Regional techniques as an adjunct to general anesthesia for pediatric extremity and spine surgery

Herman V. DeVera, Kenneth T Furukawa, Michael D. Matson, John A. Scavone, Michelle James

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The purpose of this review is to evaluate the safety of regional anesthesia techniques performed for postoperative analgesia in anesthetized children. Pediatric regional anesthesia techniques, such as nerve blocks and neuraxial injections of either local anesthetics or narcotics, can potentially reduce postoperative pain for all children undergoing surgery. However, children may react differently to anesthesia than adults, and they usually cannot tolerate the administration of regional anesthesia unless they are under general anesthesia.During a 5-year period (1999-2004) at the Shriners Hospitals for Children Northern California, 2236 regional anesthetic procedures were performed in 1809 patients. All of the regional procedures were performed with patients under general anesthesia. Ninety-one percent (1641) of patients were for orthopaedic extremity or spine surgeries. Patients ranged from 2 months to 20 years old, with 65% (1169) between the ages of 6 months and 12 years. One thousand eleven procedures were lower extremity blocks, 646 were upper extremity blocks, and 579 were neuraxial injections. Four hundred fifty-four peripheral nerve blocks were performed in patients aged 3 years or younger. Two self-limiting complications possibly related to peripheral nerve blocks were noted. No complications were noted in patients who received neuraxial injections. This retrospective review indicates that regional anesthesia techniques performed 'under general anesthesia have a low rate of complications in children. A prospective trial is recommended to establish the efficacy and safety of this practice.

Original languageEnglish (US)
Pages (from-to)801-804
Number of pages4
JournalJournal of Pediatric Orthopaedics
Volume26
Issue number6
DOIs
StatePublished - Nov 2006
Externally publishedYes

Fingerprint

General Anesthesia
Spine
Conduction Anesthesia
Extremities
Pediatrics
Nerve Block
Peripheral Nerves
Injections
Safety
Narcotics
Postoperative Pain
Local Anesthetics
Upper Extremity
Analgesia
Orthopedics
Anesthetics
Lower Extremity
Anesthesia

Keywords

  • Anesthesia for orthopaedic surgery
  • Neuraxial anesthesia in pediatric patients
  • Peripheral nerve blocks in pediatric patients
  • Peripheral nerve blocks under general anesthesia
  • Regional anesthesia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Regional techniques as an adjunct to general anesthesia for pediatric extremity and spine surgery. / DeVera, Herman V.; Furukawa, Kenneth T; Matson, Michael D.; Scavone, John A.; James, Michelle.

In: Journal of Pediatric Orthopaedics, Vol. 26, No. 6, 11.2006, p. 801-804.

Research output: Contribution to journalArticle

@article{33c0bc3f6b4744d782abbbe5b44a4dd4,
title = "Regional techniques as an adjunct to general anesthesia for pediatric extremity and spine surgery",
abstract = "The purpose of this review is to evaluate the safety of regional anesthesia techniques performed for postoperative analgesia in anesthetized children. Pediatric regional anesthesia techniques, such as nerve blocks and neuraxial injections of either local anesthetics or narcotics, can potentially reduce postoperative pain for all children undergoing surgery. However, children may react differently to anesthesia than adults, and they usually cannot tolerate the administration of regional anesthesia unless they are under general anesthesia.During a 5-year period (1999-2004) at the Shriners Hospitals for Children Northern California, 2236 regional anesthetic procedures were performed in 1809 patients. All of the regional procedures were performed with patients under general anesthesia. Ninety-one percent (1641) of patients were for orthopaedic extremity or spine surgeries. Patients ranged from 2 months to 20 years old, with 65{\%} (1169) between the ages of 6 months and 12 years. One thousand eleven procedures were lower extremity blocks, 646 were upper extremity blocks, and 579 were neuraxial injections. Four hundred fifty-four peripheral nerve blocks were performed in patients aged 3 years or younger. Two self-limiting complications possibly related to peripheral nerve blocks were noted. No complications were noted in patients who received neuraxial injections. This retrospective review indicates that regional anesthesia techniques performed 'under general anesthesia have a low rate of complications in children. A prospective trial is recommended to establish the efficacy and safety of this practice.",
keywords = "Anesthesia for orthopaedic surgery, Neuraxial anesthesia in pediatric patients, Peripheral nerve blocks in pediatric patients, Peripheral nerve blocks under general anesthesia, Regional anesthesia",
author = "DeVera, {Herman V.} and Furukawa, {Kenneth T} and Matson, {Michael D.} and Scavone, {John A.} and Michelle James",
year = "2006",
month = "11",
doi = "10.1097/01.bpo.0000235392.26666.6b",
language = "English (US)",
volume = "26",
pages = "801--804",
journal = "Journal of Pediatric Orthopaedics",
issn = "0271-6798",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Regional techniques as an adjunct to general anesthesia for pediatric extremity and spine surgery

AU - DeVera, Herman V.

AU - Furukawa, Kenneth T

AU - Matson, Michael D.

AU - Scavone, John A.

AU - James, Michelle

PY - 2006/11

Y1 - 2006/11

N2 - The purpose of this review is to evaluate the safety of regional anesthesia techniques performed for postoperative analgesia in anesthetized children. Pediatric regional anesthesia techniques, such as nerve blocks and neuraxial injections of either local anesthetics or narcotics, can potentially reduce postoperative pain for all children undergoing surgery. However, children may react differently to anesthesia than adults, and they usually cannot tolerate the administration of regional anesthesia unless they are under general anesthesia.During a 5-year period (1999-2004) at the Shriners Hospitals for Children Northern California, 2236 regional anesthetic procedures were performed in 1809 patients. All of the regional procedures were performed with patients under general anesthesia. Ninety-one percent (1641) of patients were for orthopaedic extremity or spine surgeries. Patients ranged from 2 months to 20 years old, with 65% (1169) between the ages of 6 months and 12 years. One thousand eleven procedures were lower extremity blocks, 646 were upper extremity blocks, and 579 were neuraxial injections. Four hundred fifty-four peripheral nerve blocks were performed in patients aged 3 years or younger. Two self-limiting complications possibly related to peripheral nerve blocks were noted. No complications were noted in patients who received neuraxial injections. This retrospective review indicates that regional anesthesia techniques performed 'under general anesthesia have a low rate of complications in children. A prospective trial is recommended to establish the efficacy and safety of this practice.

AB - The purpose of this review is to evaluate the safety of regional anesthesia techniques performed for postoperative analgesia in anesthetized children. Pediatric regional anesthesia techniques, such as nerve blocks and neuraxial injections of either local anesthetics or narcotics, can potentially reduce postoperative pain for all children undergoing surgery. However, children may react differently to anesthesia than adults, and they usually cannot tolerate the administration of regional anesthesia unless they are under general anesthesia.During a 5-year period (1999-2004) at the Shriners Hospitals for Children Northern California, 2236 regional anesthetic procedures were performed in 1809 patients. All of the regional procedures were performed with patients under general anesthesia. Ninety-one percent (1641) of patients were for orthopaedic extremity or spine surgeries. Patients ranged from 2 months to 20 years old, with 65% (1169) between the ages of 6 months and 12 years. One thousand eleven procedures were lower extremity blocks, 646 were upper extremity blocks, and 579 were neuraxial injections. Four hundred fifty-four peripheral nerve blocks were performed in patients aged 3 years or younger. Two self-limiting complications possibly related to peripheral nerve blocks were noted. No complications were noted in patients who received neuraxial injections. This retrospective review indicates that regional anesthesia techniques performed 'under general anesthesia have a low rate of complications in children. A prospective trial is recommended to establish the efficacy and safety of this practice.

KW - Anesthesia for orthopaedic surgery

KW - Neuraxial anesthesia in pediatric patients

KW - Peripheral nerve blocks in pediatric patients

KW - Peripheral nerve blocks under general anesthesia

KW - Regional anesthesia

UR - http://www.scopus.com/inward/record.url?scp=33750456529&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750456529&partnerID=8YFLogxK

U2 - 10.1097/01.bpo.0000235392.26666.6b

DO - 10.1097/01.bpo.0000235392.26666.6b

M3 - Article

C2 - 17065951

AN - SCOPUS:33750456529

VL - 26

SP - 801

EP - 804

JO - Journal of Pediatric Orthopaedics

JF - Journal of Pediatric Orthopaedics

SN - 0271-6798

IS - 6

ER -