Key result
Continuous peripheral nerve blocks, new local anesthetics like levobupivacaine and ropivacaine, and ultrasonography guidance offer improved safety and efficacy in pediatric regional anesthesia.
Continuous peripheral nerve blocks with newer local anesthetics and ultrasound guidance offer improved safety and efficacy for pediatric regional anesthesia.
Hypothesis-generating for ultrasound-guided continuous blocks with levobupivacaine or ropivacaine in children; prospective trials needed before adoption.
PURPOSE OF REVIEW: New topics in pediatric regional anesthesia are discussed. RECENT FINDINGS: Continuous peripheral nerve blocks, new local anesthetics and the performance of regional blocks with ultrasonography guidance are summarized. SUMMARY: Prolonged analgesia with continuous peripheral nerve blocks in the treatment of pediatric postoperative limb pain, sometimes with patient-controlled regional analgesia, should be preferred instead of continuous epidural analgesia. Levobupivacaine and ropivacaine display the same pharmacokinetic profile as racemic bupivacaine with less cardiac toxicity. Conversely, continuous infusion of these new local anesthetics offers the safest therapeutic index, especially in infants. Many adjuvants have been used, but clonidine offers clear advantages. Ultrasonography guidance blocks will probably become the reference technique for local anesthetics injection and regional anesthesia catheter placement; new training in this field should be available.
No takes yet. Share an insight, caveat, or question.
Claude Ecoffey (2007) conducted a review in Pediatric postoperative limb pain. Continuous peripheral nerve blocks, new local anesthetics, and ultrasonography guidance was evaluated. Continuous peripheral nerve blocks, new local anesthetics like levobupivacaine and ropivacaine, and ultrasonography guidance offer improved safety and efficacy in pediatric regional anesthesia.