Regional anesthesia in a very low-birth-weight neonate for a neurosurgical procedure

Abstract

We were able to successfully utilize peripheral nerve blocks and were able to blunt physiologic responses to surgical stress without compromising hemodynamic stability using high-dose opioids.

Head and neck blocks in infants, children, and adolescents

“…Frontal craniotomy, ventriculoperitoneal shunt, Omayya reservoir placement, dermatologic procedures (2–4).…”

“…Posterior fossa craniotomy (3,4) occipital neuralgia (12), migraine headaches, and cervicogenic headaches (13).…”

Levobupivacaine scalp nerve block in children

“…In this report, we suggest that levobupivacaine SNB in children can blunt hemodynamical responses to the Mayfield TM pin‐holder placement, skin incision and craniotomy, and also offers great hemodynamical stability during surgery. A levobupivacaine SNB can blunt the hemodynamic responses to skull‐pin holder, skin incision and craniotomy in adults (3), as bupivacaine does in a premature neonate without the need for high‐dose opioids (4). Remifentanil is currently indicated when a rapid recovery and neurological evaluation are desired.…”

Head and neck blocks in children: an anatomical and procedural review

“…Indications. This nerve block can be utilized for surgery that is performed on the scalp, anterior to the coronal suture including frontal craniotomies, anterior midline dermoid excisions, frontal ventriculoperitoneal shunts, Omayya reservoir placement in neonates (2) and nevus excisions on the anterior portion of the scalp (Table 2) (3).…”

“…Indications. Blockade of the superficial cervical plexus can provide sensory analgesia for the postauricular area of the scalp (lesser occipital) (2) the external pinna and the posterior auricular area as well as the temporoparietal area of the scalp (greater auricular) (9) the anterior portion of the neck (transverse cervical) and supply to the supraclavicular area (supraclavicular branch). The greater auricular nerve block has been successfully used for pain relief following tympanomastoid surgery (8) and otoplasty (9).…”