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