Advertisement

Regional analgesia in children: which drug? which block?

  • C. Dell’Oste
  • G. Ivani
  • A. Sarti
Conference paper

Abstract

In recent years there has been a trend towards increasing use of regional anaesthetic techniques in infants and children. This increasing use of any regional technique has modified both the standards of practice in paediatric anaesthesia and the management of postoperative pain. New long-acting local anaesthetics, such as ropivacaine and levobupivacaine, have become available. Catheter techniques have become routine practice for peripheral nerve blocks, improving the quality of postoperative analgesia.

Keywords

Nerve Block Biliary Atresia Postoperative Analgesia Femoral Nerve Block Peripheral Nerve Block 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Vas L, Naregal P, Sanzgiri S et al (1999) Some vagaries of neonatal lumbar epidural anaesthesia. Paediatr Anaesth 9: 217–223PubMedGoogle Scholar
  2. 2.
    Klimscha W, Chiari A, Michalek-Sauberer A et al (1998) The efficacy and safety of a clonidine/bupivacaine combination in caudal blockade for pediatric hernia repair. Anesth Analg 86: 54–61PubMedGoogle Scholar
  3. 3.
    Hammer GB (1999) Regional anesthesia for pediatric cardiac surgery. J Cardiothorac Vasc Anesth 13: 210–213PubMedCrossRefGoogle Scholar
  4. 4.
    Peterson KL, DeCampli WM, Pike NA et al (2000) A report of two hundred twenty cases of regional anesthesia in pediatric cardiac surgery. Anesth Analg 90: 1014–1019PubMedCrossRefGoogle Scholar
  5. 5.
    Giaufrè E, Dalens B, Gombert A (1996) Epidemiology and morbidity of regional anesthesia in children — a one-year prospective survey of the French-Language Society of Pediatric Anesthesiologists ( ADARPEF ). Anesth Analg 83: 904–912PubMedGoogle Scholar
  6. 6.
    Eyres RL (1995) Local anesthetic agents in infancy. Paediatr Anaesth 5: 213–218PubMedCrossRefGoogle Scholar
  7. 7.
    Knudsen K, Beckman SM, Blomberg S et al (1997) Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth 78: 507–514PubMedCrossRefGoogle Scholar
  8. 8.
    Mazoit JX, Boico O, Samii K (1993) Myocardial uptake of bupivacaine. II. Pharmacokinetics and pharmacodynamics of bupivacaine enantiomers in the isolated perfused rabbit heart. Anesth Analg 77: 477–482PubMedGoogle Scholar
  9. 9.
    Gunter JB (2002) Benefit and risks of local anesthetics in infants and children. Paediatr Drugs 4: 649–672PubMedGoogle Scholar
  10. 10.
    Karmakar MK, Aun CS, Wong EL et al (2002) Ropivacaine undergoes slower systemic absorption from the caudal epidural space in children than bupivacaine. Anesth Analg 94: 259–265PubMedGoogle Scholar
  11. 11.
    Lonnqvist PA, Westrn P, Larsson BA et al (2000) Ropivacaine pharmacokinetics after caudal block in 1–8 year old children. Br J Anaesth 85: 506–511PubMedCrossRefGoogle Scholar
  12. 12.
    Luz G, Innerhofer P, Haussier B et al (2000) Comparison of ropivacaine 0.1% and 0.2% with bupivacaine 0.2% for single-shot caudal anaesthesia in children. Paediatr Anaesth 10: 499–504PubMedCrossRefGoogle Scholar
  13. 13.
    Meunier JF, Goujard E, Dubousset AM et al (2001) Pharmacokinetics of bupivacaine after continuous epidural infusion in infants with and without biliary atresia. Anesthesiology 95: 87–95PubMedCrossRefGoogle Scholar
  14. 14.
    Kopacz DJ, Allen HW, Thompson GE (2000) A comparison of epidural levobupivacaine 0.75% with racemic bupivacaine for lower abdominal surgery. Anesth Analg 90: 642–648PubMedCrossRefGoogle Scholar
  15. 15.
    Burke D, Kennedy S, Bannister J (1999) Spinal anesthesia with 0.5% S(-)-bupivacaine for elective lower limb surgery. Reg Anesth Pain Med 24: 519–523PubMedGoogle Scholar
  16. 16.
    Ivani G, De Negri P, Conio P et al (2002) Comparison of racemic bupivacaine, ropivacaine, and levo-bupivacaine for pediatric caudal anesthesia: effects on postoperative analgesia and motor block. Reg Anesth Pain Med 27: 157–161PubMedGoogle Scholar
  17. 17.
    Eyres RL, Chalkiadis G, Taylor R (1999) Efficacy and safety of levobupivacaine as caudal anaesthesia in paediatric surgery. Inter Monitor Reg Anaesth 11:31AGoogle Scholar
  18. 18.
    Hannallah RS (1994) Who benefits when parents are present during anaesthetic induction in their children? Can J Anaesth 41: 271–275PubMedCrossRefGoogle Scholar
  19. 19.
    Conran AM, Hannallah RS (1997) Pediatric outpatient anesthesia and perioperative care. Curr Opin Anesthesiol 10: 205–208CrossRefGoogle Scholar
  20. 20.
    Kotiniemi LH, Ryhanen PT (1996) Behavioural changes and children memories after intravenous inhalation and rectal induction of anaesthesia. Paediatr Anaesth 6: 201–207PubMedCrossRefGoogle Scholar
  21. 21.
    Watcha MF, Simeon RM, White PF (1991) Effect of propofol on the incidence of postoperative vomiting after strabismus surgery in pediatric outpatients. Anesthesiology 75: 204–209PubMedCrossRefGoogle Scholar
  22. 22.
    Sarti A, Busoni P, Dell’Oste C, Bussolin L (2003) Incidence of vomiting in susceptible children under regional analgesia with two different anaesthetic techniques. Paediatr Anaesth (in press)Google Scholar
  23. 23.
    Morton NS (1998) TIVA in paediatrics: advantages and disadvantages. Paediatr Anaesth 8: 189–194PubMedCrossRefGoogle Scholar
  24. 24.
    Dalens B, Mansoor 0 (1994) Safe selection and performance of regional anesthetic techniques in children. Curr Opin Anesthesiol 7: 257–261CrossRefGoogle Scholar
  25. 25.
    Berde C (1994) Epidural analgesia in children. Can J Anaesth 41: 555–560PubMedCrossRefGoogle Scholar
  26. 26.
    Krane EJ, Jacobsen LE, Lynn AM (1987) Caudal morphine for postoperative analgesia in children: a comparison with caudal bupivacaine and intravenous morphine. Anesth Analg 66: 647–653PubMedGoogle Scholar
  27. 27.
    Lee HM, Sanders GM (2000) Caudal ropivacaine and ketamine for postoperative analgesia in children. Anaesthesia 55: 798–810CrossRefGoogle Scholar
  28. 28.
    Spear RM, Desphande JK, Maxwell LG (1988) Caudal anaesthesia in the high-risk infant. Anesthesiology 69: 407–409PubMedCrossRefGoogle Scholar
  29. 29.
    Bosemberg AT, Bland BAR, Schulte-Steinberg O et al (1989) Thoracic epidural anesthesia via caudal route in infants. Anesthesiology 69: 265–269CrossRefGoogle Scholar
  30. 30.
    Dohi S, Naito H, Takahashi T (1979) Age-related changes in blood pressure and duration of motor block in spinal anesthesia. Anesthesiology 50: 319–323PubMedCrossRefGoogle Scholar
  31. 31.
    Flantin-Bléty C, Barrier G (1995) Accidents following extradural analgesia in children. The results of a retrospective study. Paediatr Anaesth 5: 41–46CrossRefGoogle Scholar
  32. 32.
    Berde C (1992) Convulsions associated with pediatric regional anesthesia. Anesth Analg 75: 164–166PubMedCrossRefGoogle Scholar
  33. 33.
    Mahe V, Ecoffey C (1988) Spinal anesthesia with isobaric bupivacaine in infants. Anesthesiology 68: 601–603PubMedCrossRefGoogle Scholar
  34. 34.
    Krane EJ, Haberkern CM, Jacobson LE (1995) Postoperative apnoea, bradycardia, and oxygen desaturation in formerly premature infants: prospective comparison of spinal and general anesthesia. Anesth Analg 80: 7–13PubMedGoogle Scholar
  35. 35.
    Kokki H, Salonvaara M. Herrgard E et al (1999) Postdural puncture headache is not an age-related symptom in children: a prospective, open-randomized, parallel group study comparing a 22-gauge Quincke with a 22-gauge Whitacre needle. Paediatr Anaesth 9: 429–434PubMedCrossRefGoogle Scholar
  36. 36.
    Kokki H, Heikkinen M. Turunen M (2000) Needle design does not affect the success rate of spinal anaesthesia or the incidence of post-puncture complications in children. Acta Anaesthesiol Scand 44: 210–213PubMedCrossRefGoogle Scholar
  37. 37.
    McNicol LR (1994) Peripheral nerve blocks. In: Morton NS, Raine PA (eds) Paediatric day case surgery. University Press Oxford, Oxford, pp 38–53Google Scholar
  38. 38.
    Broadman LM, Hannallah RS, Belman B et al (1987) Post circumcision analgesia— a prospective evaluation of subcutaneous ring block of the penis. Anesthesiology 67: 399–402PubMedCrossRefGoogle Scholar
  39. 39.
    Dalens B, Vanneuville G, Dechelotte P (1989) Penile block via the subpubic space in 100 children. Anesth Analg 69: 41–45PubMedGoogle Scholar
  40. 40.
    Taras JS, Behrman MJ (1998) Continuous peripheral nerve block in replantation and revascularization. J Reconstr Microsurg 14: 17–21PubMedCrossRefGoogle Scholar
  41. 41.
    Sutherland ID (1998) Continuous sciatic nerve infusion: expanded case report describing a new approach. Reg Anesth Pain Med 23: 496–501PubMedGoogle Scholar
  42. 42.
    Bosenberg AT, Raw R, Boezzart AP (2002) Surface mapping of peripheral nerves in children with a nerve stimulator. Paediatr Anaesth 12: 398–403PubMedCrossRefGoogle Scholar
  43. 43.
    Dalens B, Vanneuville G, Tanguy A (1989) Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg 69: 705–713PubMedGoogle Scholar
  44. 44.
    Longo SR, Williams DP (1997) Bilateral fascia iliaca catheters for postoperative pain control after bilateral total knee arthoplasty: a case report and description of a catheter technique. Reg Anesth 22: 372–377PubMedCrossRefGoogle Scholar
  45. 45.
    Paut O, Sallabery M, Schreiber-Deturmeny E (2001) Continuous fascia iliaca compartment block in children: a prospective evaluation of plasma bupivacaine concentrations, pain scores, and side effects. Anesth Analg 92:1159–1163PubMedCrossRefGoogle Scholar
  46. 46.
    Johnson CM (1994) Continuous femoral nerve blockade for analgesia in children with femoral fractures. Anesth Intensive Care 22: 281–283Google Scholar
  47. 47.
    Tobias JD (1994) Continuous femoral nerve block to provide analgesia following femur fracture in a paediatric ICU population. Anesth Intensive Care 22: 616–618Google Scholar
  48. 48.
    Dalens B, Vanneuville G, Tanguy A (1987) A new parascalene approach to the brachial plexus in children: comparison with the supraclavicular approach. Anesth Analg 66: 1264–1271PubMedGoogle Scholar
  49. 49.
    Scott DA, Schweitzer SA, Selander DE (1997) Continuous axillary brachial plexus block for postoperative pain relief. Intermittent bolus versus continuous infusion. Reg Anesth 22: 357–362PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 2004

Authors and Affiliations

  • C. Dell’Oste
  • G. Ivani
  • A. Sarti

There are no affiliations available

Personalised recommendations