Combined Spinal and Caudal Epidural Anesthesia for Prolonged Surgical Procedures in Pediatric-Aged Patients: A Report of Two Cases

Abstract

With emerging evidence that specific anesthetic agents may affect neurocognitive outcomes, there has been renewed interest in the applications of spinal anesthesia in neonates and infants. Because of its short duration of action, spinal anesthesia in infants is generally limited to procedures lasting less than 70 -75 min. To avoid this limitation, we report a technique combining spinal and caudal epidural anesthesia. We present two infants in whom this technique was used to provide surgical anesthesia (without general anesthesia or airway manipulation) for two cases lasting more than 90 min. The technique used is presented, its applications discussed, and previous reports reviewed.