• Robin G Cox.
• Department of Anesthesia, Alberta Children's Hospital, University of Calgary, 2888 Shaganappi Trail N.W., Calgary, AB, T3B 6A8, Canada, robin.cox@albertahealthservices.ca.
• Can J Anaesth. 2014 Jan 1;61(1):72-5.

UnlabelledFrancis G. Ruston MD CITATION: Ruston FG. Epidural anaesthesia in infants and children. Can Anaesth Soc J 1954: 1: 37-44.PurposeThe author describes the use of single-shot epidural anesthesia in a series of 44 infants and children. The patients were anesthetized in hospitals in Hamilton, Ontario from 1949 until the time of publication in 1954. The study aimed to describe the indications and efficacy of this technique as well as any apparent complications. A detailed description of the management of these patients was given, including many tips and suggestions that are still applicable in 2013.Principal FindingsSeventy-seven infants and children received epidural anesthesia for a variety of procedures, particularly for pyloric stenosis. Forty-four of the procedures were carried out by the author. All patients survived, apart from one child who died of recurrent intestinal obstruction unrelated to the anesthetic. It was found, after some experience, that the sitting position was preferable for epidural needle insertion. Use of the hanging drop technique for identification of the epidural space proved to be simple and reliable. Surgical conditions were found to be excellent and relaxation was profound; however, some sedation was often required to obtain optimal conditions for surgery. The surgeons became sold on the technique and began to request an epidural on a regular basis.ConclusionsEpidural anesthesia in infants and young children is effective for a variety of procedures below the diaphragm, even in moribund patients.

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