Pediatric anesthesia & critical care
Awake caudal anesthesia in ex‐premature infants undergoing lower abdominal surgery: A narrative review
Authors' conclusion
There is insufficient evidence to validate or refute the benefits of the use of "awake" caudal anesthesia in premature and ex-premature infants.
Study context
- Population
- Premature and ex-premature infants undergoing lower abdominal surgery45 articles
- Participants
- 1,548 participants
- Comparison
- Awake caudal vs Sedated caudal vs CSEA
- Awake caudaln = 558
- Sedated caudaln = 837
- CSEAn = 153
- Outcome
- Anesthetic failure rate
Methodological detailsPRISMA-guided literature search, Mostly case reports; no high-quality RCTs; 8 single-centre retrospective reviews; insufficient data for meta-analysis
- PRISMA-guided literature search
- Mostly case reports; no high-quality RCTs; 8 single-centre retrospective reviews; insufficient data for meta-analysis
Main finding
As reported in the abstract
- Overall anesthetic failure rate
- 7.2% (71.9:1000 caudals)
Safety
High spinal anesthesia
Per 1000 caudals Awake caudal 19.7:1000 · Sedated caudal 10.7:1000 · CSEA 6.6:1000
| Outcome | Awake caudal | Sedated caudal | CSEA |
|---|---|---|---|
| Perioperative apnea, incidence (range) | 7.62% (range 0%–60%) | 8.16 (range 0%–24%) | 5.53% (range 0%–14.3%) |
- High spinal anesthesia — High spinal anesthesia overall
- 0.84%, or 8.35:1000 caudals
Original publication
Awake caudal anesthesia in ex‐premature infants undergoing lower abdominal surgery: A narrative review. Paediatr Anaesth. Published 26 December 2023. doi:10.
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