History of pediatric regional anesthesia

Brown, T. C. K.

doi:10.1111/j.1460-9592.2011.03636.x

Cited by 46 publications

(24 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The new interest for the use of spinal anesthesia rose three decades ago when awake spinal anesthesia was introduced for herniotomies in preterm neonates with high risk of apnea associated with general anesthesia (2). However, spinal anesthesia is a feasible technique not only in neonates but also in older children and adolescents (3).…”

Section: Introductionmentioning

confidence: 99%

Spinal blocks

Kokki

2011

Pediatric Anesthesia

View full text Add to dashboard Cite

Every anesthetist should have the expertise to perform lumbar puncture that is the prerequisite to induce spinal anesthesia. Spinal anesthesia is easy and effective technique: small amount of local anesthetic injected in the lumbar cerebrospinal fluid provides highly effective anesthesia, analgesia, and sympathetic and motor block in the lower part of the body. The main limitation of spinal anesthesia is a variable and relatively short duration of the block with a single-injection of local anesthetic. With appropriate use of adjuvant or combining spinal anesthesia with epidural anesthesia, the analgesic action can be controlled in case of early recovery of initial block or in patients with prolonged procedures. Contraindications are rare. Bleeding disorders and any major dysfunction in coagulation system are rare in children, but spinal anesthesia should not be used in children with local infection or increased intracranial pressure. Children with spinal anesthesia may develop the same adverse effects as has been reported in adults, but in contrast to adults, cardiovascular deterioration is uncommon in children even with high blocks. Most children having surgery with spinal anesthesia need sedation, and in these cases, close monitoring of sufficient respiratory function and protective airway reflexes is necessary. Postdural puncture headache and transient neurological symptoms have been reported also in pediatric patients, and thus, guardians should be provided instructions for follow-up and contact information if symptoms appear or persist after discharge. Epidural blood patch is effective treatment for prolonged, severe headache, and nonopioid analgesic is often sufficient for transient neurological symptoms.

show abstract

Section: Introductionmentioning

confidence: 99%

Spinal blocks

Kokki

2011

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…The caudal technique is extensively described by Key in 1994. 5 When regional anesthesia is given to older children, some variables such as the intervention site, age, and presence of chronic disease, cooperativeness and parental preferences should be considered. In present study we compared caudal block with spinal block in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study between Pediatric Spinal and Caudal Anesthesia

2015

IJSR

View full text Add to dashboard Cite

Introduction: Regional anesthesia in children was first studied by August Bier in 1899. Since then, spinal anesthesia was known to be practiced for several years with a series of cases published as early as in 1909-1910. The appearance of neuromuscular blocking agents and the development of volatile anesthetics in the forties shifted the techniques toward general anesthesia. Material & Method: All the study patients were examined on previous day of the surgery & all routine investigations were noted. All the patients were kept nil by mouth for 6 hours before the surgery. Patient's guardian or the parents were informed about anesthetic procedure and the informed consent was taken. Result & Conclusion: In the present study the effectiveness of the caudal anesthesia was compared with the spinal anesthesia. The dosage was taken as per mg/kg for producing adequate anesthesia as per the guidance provided in the different other studies but different authors.

show abstract

“…9 Although the first successful spinal anesthesia was performed in an 11-year old by August Bier in 1898, 10 and the first caudal anesthesia was performed in 1933, 11 in the mid-20th century, US doctors rarely performed regional anesthesia in children. 12 Working initially in a cadaver laboratory to determine the doses of local anesthetic needed to achieve satisfactory dermatomal spread, and then with children in IRB-approved research trials, Melman et al 9,13 was among the first to demonstrate the effectiveness of neural blockade, particularly the caudal approach to the epidural space, in pediatric anesthesia. Indeed, her original study was met with substantial skepticism and was rejected by one of the editors at Anesthesia and Analgesia.…”

mentioning

confidence: 99%

At the birth of pediatric anesthesia in Mexico: An interview with Dr. Estela Melman, a pioneering woman in medicine

Ahmed

Mai

Skinner

et al. 2018

Pediatric Anesthesia

View full text Add to dashboard Cite

Summary Dr. Estela Melman (1939‐present), Professor in the Department of Anesthesiology, the American British Cowdray Medical Center, Mexico, is an influential pioneer who has shaped the scope and practice of pediatric anesthesia in Mexico and throughout the world. Her early work to reintroduce neural blockade into routine pediatric anesthetic care, particularly the caudal approach to the epidural space, helped to transform current anesthesia practice. Based on a series of interviews held with Dr. Melman between 2016 and 2017, this article reviews the remarkable career of a pioneering pediatric anesthesiologist.

show abstract

History of pediatric regional anesthesia

Cited by 46 publications

References 43 publications

Spinal blocks

Spinal blocks

Comparative Study between Pediatric Spinal and Caudal Anesthesia

At the birth of pediatric anesthesia in Mexico: An interview with Dr. Estela Melman, a pioneering woman in medicine

Contact Info

Product

Resources

About