Head and neck blocks in infants, children, and adolescents

Suresh, Santhanam; Voronov, Polina

doi:10.1111/j.1460-9592.2011.03701.x

Cited by 25 publications

(18 citation statements)

References 23 publications

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“…Various locations of the greater occipital nerve have been reported, yet, no information on dissections of the greater occipital nerve in the children could be obtained. Suresh and Voronov state: “The midpoint of a line drawn between the mastoid process and the midline will be a good guide to the location of the greater occipital nerve.” However, this statement seems a bit vague, as the exact point on the midline is not described.…”

Section: Discussionsupporting

confidence: 50%

“…In this anatomical study, for the infant sample, the distance between the external occipital protuberance and the greater occipital nerve was on average 23 mm apart, which can be described as 44% of the distance between the external occipital protuberance and the mastoid process (measured at 51 mm). Although the results of our study and that of Suresh and Voronov appear similar, the difference could possibly be attributed to the difference in the age of the sample population. In this study, only five infant cadavers (with a mean age of 51.4 days) were used, due to the infant cadavers being a scarce resource.…”

Section: Discussionmentioning

confidence: 99%

“…Suresh and Voronov suggested that in children, the midpoint of a line drawn between the mastoid process and the midline, is a good guide to the location of the greater occipital nerve . However, no information from anatomical dissections of the greater occipital nerve in children could be found to confirm this.…”

Section: Introductionmentioning

confidence: 99%

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Anatomy of the greater occipital nerve block in infants

Prigge

Schoor

Bösenberg

2019

Pediatric Anesthesia

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Background Pain relief for posterior fossa craniotomies as well as occipital neuralgia, are indications for the use of the greater occipital nerve block in children. The greater occipital nerve originates from the C2 spinal nerve and is accompanied by the occipital artery as it supplies the posterior scalp. Aims The aim of this study was to develop a unique, yet simple technique for blocking the greater occipital nerve in children through the evaluation of the anatomy of this nerve and the accompanying occipital artery in the occipital region. Methods The greater occipital nerve and occipital artery were dissected and exposed in six formalin‐fixed cadavers (five infants [average age of 51.4 days] and one 2‐year‐old) from the Department of Anatomy, University of Pretoria. Measurements between the nerve and selected bony landmarks were obtained. The relationship between the greater occipital nerve and the occipital artery at the trapezius muscle hiatus was also evaluated. Results The greater occipital nerve is on average 22.6 ± 5.6 mm from the external occipital protuberance in infants. The average width of the medial three fingers measured at the proximal interphalangeal joint, for each respective cadaver is 20.4 ± 4.0 mm, with a strong correlation coefficient of 0.97 between the aforementioned distances. In 83.3% of the specimens, the occipital artery lies lateral to the greater occipital nerve at the trapezius muscle hiatus. Conclusion In infants, the greater occipital nerve can be blocked approximately 23 mm from the external occipital protuberance, medial to the occipital artery. This distance is equal to the width of the medial three fingers at the proximal interphalangeal joint of the patient.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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Anatomy of the greater occipital nerve block in infants

Prigge

Schoor

Bösenberg

2019

Pediatric Anesthesia

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“…Infraorbital nerve blocks (IONB) are often performed in the pediatric population for the management of postoperative pain associated with cleft lip surgery . To perform IONB, whether by the transcutaneous or intraoral approach, the location of the infraorbital foramen (IOF) must first be recognized.…”

Section: Introductionmentioning

confidence: 99%

Infraorbital foramen location in the pediatric population: A guide for infraorbital nerve block

Zdilla

Russell

Koons

2018

Pediatric Anesthesia

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The infraorbital foramen was located within 2 mm, on average, from the nasospinale-to-jugale midpoint regardless of age group. Therefore, the nasospinale-to-jugale midpoint may serve as useful means of identifying the location of the infraorbital foramen in the pediatric population and aid in optimizing infraorbital nerve block procedures. The information in this report is valuable in general, but may be particularly useful in developing countries where there is a lack of ultrasound training and availability for health care providers; or places where infraorbital nerve block may be the sole anesthetic modality for cleft lip surgery, even among adolescent patients.

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“…OSA itself predisposes patients to opioid-induced respiratory depression and airway obstruction; 3-5 the patients are often obese, 6 which can confer additional sensitivity to anesthetic agents, muscle relaxants, and opioids when compared with the nonobese patient. [10][11][12] Although continuous peripheral nerve blocks have been shown to reduce both postoperative pain and opioid requirements for other surgical procedures, 13 their role in head and neck surgery remains uncertain. 8 The American Society of Anesthesiologists practice guidelines recommend incorporating regional anesthesia into the perioperative care of OSA patients to minimize the use of anesthetic and analgesic agents that may impact respiratory physiology.…”

mentioning

confidence: 99%