Complications of Intervertebral Epidural Anesthesia in Children

Intervertebral epidural blocks were performed in 1, 287 patients under the age of 16 years during 1980-1995. The patients' ages ranged from 5 months to 15 years 9 months and weights from 6.51 to 89.5kg. Complications included dural puncture in 17 patients, blood reflux in 5, suspected local anesthetics toxicity in 4, and epidural abscess in 1. Neither total spinal block nor neurological damage were noted. A 20-gauge Tuohy needle was used in 10 of the 17 dural punctures. The high incidence of dural puncture in these cases may be related to the unskilled handling of this size of needle. The epidural abscess occurred in a patient suffering from herpes zoster. The abscess might have been due to insufficient sterilization of the skin around the epidural catheter. In this case, laminectomy and drainage were needed but the patient was discharged without any neurological sequelae. As the number of cases of pediatric intervertebral epidural anesthesia has increased rapidly in recent years, procedures should be carried out carefully and prudentially.