Caudal anesthesia in infants and children
Sawasato, K.; Tamiya, K.; Takahashi, T.
Masui. Japanese Journal of Anesthesiology 30(8): 809-813
1981
ISSN/ISBN: 0021-4892 PMID: 7321171 Document Number: 181022
Although caudal anesthesia has become popular, there is little information regarding the relationship between the local anesthetic dosage and blood concentration after caudal anesthesia in children. Applying homogeneous enzyme immunoassay, plasma concentrations of lidocaine were measured and compared after administration of lidocaine with and without epinephrine for caudal anesthesia in 52 infants and children aged 1 day to 5 yr. With the dosage of lidocaine with epinephrine, 8 and 11 mg/kg, the peak plasma concentrations of lidocaine were 2.3 .+-. 0.3 .mu.g/ml (mean .+-. SE), seen at 50 min after the administration and 3.0 .+-. 0.2 .mu.g/ml at 30-50 min later, respectively. When lidocaine, 8 or 11 mg/kg, without epinephrine was administered, the peak plasma concentrations were 4.5 .+-. 0.5 and 4.5 .+-. 0.3 .mu.g/ml, indicating almost a toxic level of lidocaine for adults. Although the toxic level of lidocaine for infants and children has not been established, these data suggest, as far as plasma lidocaine concentration is concerned, that caudal anesthesia in infants and children can be given safely using lidocaine with epinephrine.