Pediatric Regional Anesthesia: an Update

Abstract

The purpose of this study was to review the recent literature describing techniques, outcomes, and complications in pediatric regional anesthesia primarily among neonates and infants. Regional anesthetic techniques can be safely performed in anesthetized children, and is so widespread, that it has become accepted as standard of practice. Spinal anesthesia in the neonate requires a larger dose of local anesthetic than in adults, yet has a shorter duration of action. Neuraxial technique combined with sedation or light general anesthesia is commonly used for hernia repairs. In preterm and ex-preterm infants, awake regional techniques are reasonable alternatives. Neuraxial catheters can deliver local anesthetics and opioids both intraoperatively and postoperatively for effective pain control in all age groups including neonates. Ultrasound guidance has rapidly become the norm to ensure successful peripheral nerve blocks and abdominal wall blocks with the least amounts of local anesthetics. The dose of local anesthetic should be adjusted for each patient based on the recommended range. Regional anesthesia has shown to be safe and is being increasingly practiced. But safety should be the priority and adequate precautions should be taken to reduce potential complications.