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Continuous Caudal Block in an Infant with Arthrogryposis Multiplex Congenita
  1. Holly G. Jense, MD*,
  2. Peter S. A. Glass, MD and
  3. Robert D. Fitch, MD
  1. From the Duke University Medical Center, Durham, North Carolina
  2. *Resident, Department of Anesthesiology, Duke University Medical Center, Durham, NC.
  3. Assistant Professor, Department of Anesthesiology, Duke University Medical Center, Durham, NC.
  4. Assistant Professor, Department of Orthopedics, Duke University Medical Center, Durham, NC.


Arthrogryposis multiple congenita is a syndrome for which multiple surgical procedures are often necessary to correct orthopedic deformities. Patients with this syndrome present multiple problems, and regional anesthesia has been specifically recommended for their anesthetic management. The ability to perform a continuous caudal block in neonates and small infants is limited because of the relatively large size of available continuous epidural catheters. This article discusses the anesthetic problems associated with the management of this syndrome and describes a means of obtaining a continuous caudal block using a 22-gauge, 2-cm butterfly needle as well as the doses required to provide continuous caudal blockade in an infant weighing 4.9 kg.

  • Arthrogryposis congenita
  • Anesthetic techniques
  • peridural
  • caudal
  • Anesthesia: pediatric

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