Lower limb nerve blocks in children using unsheathed needles and a nerve stimulator

Abstract

Summary

Student Anesthetist Learning Curve Perspectives on Sciatic Nerve Localization Proficiency - A Pilot Study

“…Difficulty arises when there is anatomical variation, seen particularly in developing children and obese patients where landmarks are difficult to localize in the varied depths of deep-seated nerves (Bosenberg, 1995). Seeking paresthesias as a sign of accurate needle placement requires the patient s cooperation that is unlikely to be anticipated in a frightened child.…”

“…Major nerve blockade in children is considered by some to be unnecessarily invasive, but has been found by several authors to provide good analgesia (Bosenberg, 1995). Future technologies like the NerveSeeker described by Raymond (1992), is just one example of an alternate instrument for locating peripheral nerves.…”

“…Smith and Siggins (1988) anesthetized. This is the usual situation in which regional anesthesia is performed in children (Bosenberg, 1995).…”

“…Sciatic nerve blockade can potentially mask the development of a compartmental syndrome. This is a particular concern of the orthopedic surgeon, especially when pain, an early warning sign of compartmental syndrome is removed by successful blockade (Bosenberg, 1995).…”

“…Bosenberg (1995) noted that variations exist in the relative depths of key structures used in locating nerves in the growing child.…”