Caudal Anesthesia for Cardiac Catheterization in Children

Following the caudal epidural administration of lidocaine 10mg/kg, pulmonary arterial pressure, aortic pressure and heart rate were measured before and one year after surgical treatment of heart defects in 7 children with congenital heart disease (ventricular septal defects, patent ductus arteriosus, atrioventricular canal) and pulmonary hypertension. Mean pulmonary arterial pressure was 34mmHg before surgery and increased to 40mmHg 15 minutes after injection of lidocaine. After correction of congenital heart defects, mean pulmonary arterial pressure was 15mmHg and slightly increased after injection. Following the administration of lidocaine, mean aortic pressures were decreased by 6% and 5% respectively before and after surgical treatment of congenital heart defects. Heart rate stayed unchanged after injection. It is concluded that caudal anesthesia is undesirable in the children with congenital heart disease and pulmonary hypertension, but it is useful for cardiac catheterization in those without pulmonary hypertension.