Regional techniques as an adjunct to general anesthesia for pediatric extremity and spine surgery

被引:18
|
作者
DeVera, Herman V.
Furukawa, Kenneth T.
Matson, Michael D.
Scavone, John A.
James, Michelle A.
机构
[1] Shriners Hosp Children No Calif, Dept Anesthesiol, Sacramento, CA 95817 USA
[2] Shriners Hosp Children No Calif, Dept Orthopaed, Sacramento, CA 95817 USA
关键词
anesthesia for orthopaedic surgery; regional anesthesia; peripheral nerve blocks in pediatric patients; neuraxial anesthesia in pediatric patients; peripheral nerve blocks under general anesthesia;
D O I
10.1097/01.bpo.0000235392.26666.6b
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The purpose of this review is to evaluate the safety of regional anesthesia techniques performed for postoperative analgesia in anesthetized children. Pediatric regional anesthesia techniques, such as nerve blocks and neuraxial injections of either local anesthetics or narcotics, can potentially reduce postoperative pain for all children undergoing surgery. However, children may react differently to anesthesia than adults, and they usually cannot tolerate the administration of regional anesthesia unless they are under general anesthesia. During a 5-year period (1999-2004) at the Shriners Hospitals for Children Northern California, 2236 regional anesthetic procedures were performed in 1809 patients. All of the regional procedures were performed with patients under general anesthesia. Ninety-one percent (1641) of patients were for orthopaedic extremity or spine surgeries. Patients ranged from 2 months to 20 years old, with 65% (1169) between the ages of 6 months and 12 years. One thousand eleven procedures were lower extremity blocks, 646 were upper extremity blocks, and 579 were neuraxial injections. Four hundred fifty-four peripheral nerve blocks were performed in patients aged 3 years or younger. Two self-limiting complications possibly related to peripheral nerve blocks were noted. No complications were noted in patients who received neuraxial injections. This retrospective review indicates that regional anesthesia techniques performed under general anesthesia have a low rate of complications in children. A prospective trial is recommended to establish the efficacy and safety of this practice.
引用
收藏
页码:801 / 804
页数:4
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