ABSTRACT

Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extre-mely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe app-lication 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 defor-mity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaest-hesia 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