A Randomized Controlled Study of Combined Spinal-Epidural Analgesia Using a 25G Fine Needle Single Puncture in Children
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Keywords

25G fine needle single puncture
Children
Combined spinal-epidural anesthesia
Hydromorphone

DOI

10.26689/jcnr.v9i12.13465

Submitted : 2025-12-16
Accepted : 2025-12-31
Published : 2026-01-15

Abstract

Objective: To investigate the efficacy and safety of combined spinal-epidural (CSE) anesthesia using a 25G spinal fine needle via a single puncture for lower limb surgery in children. Methods: Sixty pediatric patients scheduled for surgery were randomly divided into two groups, with 30 patients in each. The control group received subarachnoid anesthesia with 2–2.5 mL of 0.33% ropivacaine. The experimental group received the same ropivacaine dose, followed by withdrawal of the needle to the epidural space and administration of 0.1 mg hydromorphone diluted to 5 mL. The anesthetic and analgesic effects, incidence of complications, and postoperative family satisfaction were observed in both groups. Results: Compared with the control group, the experimental group showed a higher anesthesia success rate, a shorter onset time, and a longer maintenance time of anesthesia (p < 0.05). Postoperative analgesia at various time points was significantly better in the experimental group (p < 0.05). The total incidence of complications was lower in the experimental group, though the difference was not statistically significant (p > 0.05). Family satisfaction was significantly higher in the experimental group (p < 0.05). Conclusion: CSE anesthesia using a 25G fine needle via a single puncture for pediatric lower limb surgery is safe and effective. It can significantly improve surgical outcomes and is worthy of clinical promotion.

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