Ultrasonographic guidance in pediatric regional anesthesia. Part 2: techniques

Abstract

The benefits of regional anesthesia are well documented. The downsides of such techniques have been a significant failure rate and a potential for serious complications. Nearly, all regional blocks were first described as essentially 'blind' techniques. The development of high-resolution portable ultrasound (US) has made the use of US for regional anesthesia possible. Improved understanding of sonographic anatomy should lessen both the failure rate and the possibility of incurring serious complications. Natural caution has dictated that only a selection of blocks used in adults has been commonly used in pediatric practice, but with the aid of US, the repertoire of blocks for infants and children may be widened. The second part of this review will concentrate on the practice of both peripheral and central blocks.

Ultrasound-guided proximal and distal sciatic nerve blocks in children

“…For the last three years ultrasonography has been used routinely in the performance of peripheral nerve blocks in children and adults. An excellent two-part study has been published that illustrates the basic physics of ultrasound and the ultrasonographic appearance of the different neuronal structures in children [4,5].…”

Regional Anesthetic Techniques for the Pediatric Patient

“…Although these regional techniques are safe, they are not without risk [ 51,144 ] . It is hopeful that the use of ultrasonography should decrease some of these risks [ 41 ] . Regional anesthesia can be an important component to multimodal analgesia.…”

“…The development of high-resolution portable ultrasound (US), analysis of anatomic relationships, and, most importantly, observation in the spread of administered local anesthetics have made this modality feasible for pediatric regional anesthesia [37][38][39][40] . To develop skill in the use of US, one should attend an US-guided regional anesthesia course, begin with simple blocks, then progress to the more complicated procedures as experience develops [ 41 ] .…”

The regional anesthesia for surgical correction of the malformation of upper extremities in pediatric

“…Уль-тразвуковая навигация и электростимуляция пери-ферических нервов значительно повышают уровень безопасности блокад и успех их выполнения [3,19,20,21,26,36,41].…”