Caudal anesthesia for vascular access procedures in two extremely small premature neonates

Amr E. Abouleish, Dai H. Chung, Marvin Cohen

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


With advances in neonatology, there is an increasing need for central vascular access in extremely small (<1,000 g) premature infants. Although the use of peripherally inserted central venous lines have become common practice, surgeons still frequently perform central venous line placements via cut-down in difficult access patients. The advantages of general anesthesia for vascular access procedures are obvious for optimal pain control and ideal operative exposure; however, extremely premature infants are at significant risk for prolonged endotracheal intubation with postoperative apneas. We report two cases where regional caudal anesthesia with bupivacaine and clonidine without intubation was successfully utilized at bedside during central venous line placements in premature infants weighing <600 g. The operative field was ideal with adequate motor and sensory block with caudal anesthesia and both infants received only oxygen by nasal cannula.

Original languageEnglish (US)
Pages (from-to)749-751
Number of pages3
JournalPediatric Surgery International
Issue number9
StatePublished - Sep 2005


  • Central venous access
  • Premature infants
  • Regional anesthesia

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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