Title

Pediatric neuraxial blockade

UMMS Affiliation

Department of Anesthesiology

Date

7-1993

Document Type

Article

Medical Subject Headings

Anesthesia, Caudal; Anesthesia, Conduction; Anesthesia, Epidural; Anesthesia, Spinal; Child; Child, Preschool; Humans; Infant

Disciplines

Anesthesiology

Abstract

Regional anesthetic techniques for children have recently enjoyed a justified resurgence in popularity. Intraoperative blockade of the neuraxis, whether by the spinal or epidural route, provides excellent analgesia with minimal physiologic alteration and, with an indwelling catheter, can provide continuous pain relief for many days postoperatively. As a supplement to general anesthesia, local anesthetic blockade of the neuraxis decreases the total amount of general anesthetic required for surgery, hastens emergence, and allows for a better postoperative experience by providing a pain-free emergence from general anesthesia. Although some practitioners contend that a regional block on an already anesthetized child adds to the risk of the general anesthetic itself, in experienced hands the risks are negligible and the benefits dramatic. In this review of caudal and lumbar epidural and subarachnoid blockade in infants and children, anatomy, physiologic alterations, and pharmacology pertinent to the three types of neuraxial blockade are described, with the aim of providing the practicing anesthesiologist with the foundation needed to perform these blocks with relative confidence.

Rights and Permissions

Citation: J Clin Anesth. 1993 Jul-Aug;5(4):342-54. DOI 10.1016/0952-8180(93)90131-W

Related Resources

Link to Article in PubMed