Continuous central and perineural infusions for postoperative pain control in children

Current Opinion in Anaesthesiology
Giorgio Ivani, Valeria Mossetti

Abstract

Continuous infusion remains the technique of choice when there is a prolonged operation or intense postoperative pain is anticipated. Supplementing a general anesthesia with a nerve block can result in a pain-free awakening and postoperative analgesia without the potentially deleterious effects associated with parenteral opioids. The literature confirms the very low rate of complications and adverse effects of regional anesthesia in children. Clinicians need to be aware of the key points for performing a block and placing a catheter in children: good knowledge of anatomic and physiologic differences between adults and children is necessary; the use of newer local anesthetics, such as ropivacaine and levobupivacaine, increases the therapeutic window; and moreover it is mandatory to work with dedicated pediatric equipment. The introduction of high-resolution portable ultrasound brought a great advance for the pediatric anesthesiologists; ultrasound-guided visualization of anatomic structures, in fact, allows greater precision of needle and catheter placement, and confirmation that the drug is deposited in the site of choice. This article reviews the safety and efficacy of central and perineural continuous infusions for postoperat...Continue Reading

References

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Jul 23, 2005·Anesthesia and Analgesia·Hans-Jürgen RappT Grau
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Citations

Dec 22, 2010·British Journal of Anaesthesia·J E ChellyA Fanelli
Mar 28, 2012·Paediatric Anaesthesia·Adrian Bosenberg
Sep 8, 2011·Paediatric Anaesthesia·Adrian Bosenberg
Nov 22, 2011·Paediatric Anaesthesia·Tim GearyBoris Zernikow
Jun 27, 2018·Journal of Perioperative Practice·Michelle Bennett
Oct 5, 2016·Experimental and Therapeutic Medicine·Yan ZhangWen-Bo Yi
Jun 20, 2019·Minerva anestesiologica·Andrea Gentili
May 9, 2015·Journal of Pediatric Orthopedics·Chandra H LloydTodd Milbrandt
Jun 3, 2021·Children·Costanza TognonPiergiorgio Gamba

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