Regional Anesthesia in Children

Dalens, B

doi:10.1016/b978-0-443-06959-8.00081-9

Cited by 22 publications

(28 citation statements)

References 259 publications

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“…After aseptic skin draping, the skin was pierced with a sharp needle, and a short blunt needle (Plexufix 25-mm, 24-gauge needle; B. Braun Medical, Melsungen, Germany) was introduced at a 60°to 90°angle to the skin, until the perception of two losses of resistance corresponding to the crossing of the fascia lata and the fascia iliaca. If aspiration yielded no blood, 0.25% of ropivacaine with epinephrine (1:200,000) was injected using a protocol based on children's weight: 1.0 mL/kg for 10 kg, 15 mL for 20 kg, 20 mL for 30 kg, 22.5 mL for 40 kg, and 25 mL for N 40 kg [7]. For the control group, 15 minutes before the end of surgery 0.5 μg/kg of IV fentanyl was injected as a loading dose; then the PCA device was connected to give fentanyl at a continuous dose of 0.15 μg/kg/hr, bolus doses of 0.25 μg/kg, and lockout time of 10 minutes [8][9][10].…”

Section: Methodsmentioning

confidence: 99%

Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children

Kim

et al. 2011

Journal of Clinical Anesthesia

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Section: Methodsmentioning

confidence: 99%

Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children

Kim

et al. 2011

Journal of Clinical Anesthesia

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“…Connections between C fibers (slower polymodal nociceptors) and dorsal horn neurons are not mature before the second week of postnatal life. There is also a lower pain threshold in infants, with a negative correlation with their age [8,9]. Major burn injury results in a local and systemic inflammatory response syndrome throughout the body.…”

Section: Mechanism Of Burn Painmentioning

confidence: 96%

Analgesia and sedation for children undergoing burn wound care

Bayat

Ramaiah

Bhananker

2010

Expert Review of Neurotherapeutics

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Standard care of burn wounds consists of cleaning and debridement (removing devitalized tissue), followed by daily dressing changes. Children with burns undergo multiple, painful and anxiety-provoking procedures during wound care and rehabilitation. The goal of procedural sedation is safe and efficacious management of pain and emotional distress, requiring a careful and systematic approach. Achieving the best results needs understanding of the mechanisms of pain and the physiologic changes in burn patients, frequent evaluation and assessment of pain and anxiety, and administration of suitable pharmacological and nonpharmacological therapies. Pharmacological therapies provide the backbone of analgesia and sedation for procedural pain management. Opioids provide excellent pain control, but they must be administered judiciously due to their side effects. Sedative drugs, such as benzodiazepines and propofol, provide excellent sedation, but they must not be used as a substitute for analgesic drugs. Ketamine is increasingly used for analgesia and sedation in children as a single agent or an adjuvant. Nonpharmacological therapies such as virtual reality, relaxation, cartoon viewing, music, massage and hypnosis are necessary components of procedural sedation and analgesia for children. These can be combined with pharmacological techniques and are used to limit the use of drugs (and hence side effects), as well as to improve patient participation and satisfaction. In this article, we review the pathophysiologic changes associated with major thermal injury in children, the options available for sedation and analgesia for wound care procedures in these children and our institutional guidelines for procedural sedation.

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“…However, they carry a risk of inadvertent vascular puncture or pneumothorax. Because of these issues, they are generally not recommended for routine use in pediatric patients except for those practitioners with a great deal of experience [6]. …”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided supraclavicular brachial plexus block in pediatric patients -A report of four cases-

Yang

Cho

Kwon

et al. 2010

Korean J Anesthesiol

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Supraclavicular brachial plexus blocks are not common in pediatric patients due to the risk of pneumothorax. Ultrasonography is an important tool for identifying nerves during regional anesthesia. Directly visualizing the target nerves and monitoring the distribution of the local anesthetic are potentially significant. In addition, ultrasound monitoring helps avoid complications, such as inadvertent intravascular injection or pneumothorax. This paper reports four cases of pediatric patients who received ultrasound-guided supraclavicular brachial plexus block for upper limb surgery.

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Regional Anesthesia in Children

Cited by 22 publications

References 259 publications

Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children

Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children

Analgesia and sedation for children undergoing burn wound care

Ultrasound-guided supraclavicular brachial plexus block in pediatric patients -A report of four cases-

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