GAZI MEDICAL JOURNAL, vol.23, no.4, pp.145-147, 2012 (ESCI)
Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extremely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe application of caudal anaesthesia for inguinal hernia repair in three cases with severe congenital anomalies (Joubert syndrome, I-cell syndrome). The three patients concerned had congenital anomalies including serious facial deformity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaesthesia for inguinal hernia surgery in order to avoid complications associated with general anaesthesia. Caudal block was performed and 1 mL/kg levobupivacaine 0.25% administered. We conclude that caudal epidural anaesthesia can be an effective, suitable and safe anaesthetic technique for inguinal herniotomy without the need for general anaesthesia or endotracheal intubation in children with severe congenital anomalies.