How do I do it: Continuous local anesthetic infusion for children with spinal dysraphism undergoing major reconstruction of the lower urinary tract

Wild, Trevor T.; Chalmers, David J.; Bielsky, Alan R.; Wilcox, Duncan T.

doi:10.1016/j.jpurol.2013.12.005

Cited by 7 publications

(2 citation statements)

References 5 publications

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“… 8 Central neuraxial blockade for postoperative analgesia is contraindicated in patients with spinal dysraphism. 8 Wild et al 9 used a subcutaneous catheter for continuous local anesthetic infusion in patients with spinal dysraphism and provided effective postoperative analgesia. However, subcutaneous infected seromas were observed as a complication in these patients.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound guided transversus abdominis plane block

Çevikkalp

Erbüyün

et al. 2018

SMJ

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Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated. In this study, we present 5 pediatric cases in which major abdominal surgery was performed but central neuraxial blockade could not be carried out due to spinal abnormalities.

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Section: Discussionmentioning

confidence: 99%

Ultrasound guided transversus abdominis plane block

Çevikkalp

Erbüyün

et al. 2018

SMJ

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“…Recurrent urinary tract stones are a difficult problem in patients with spinal deformities, because of the higher rate of complications and technical difficulties ( 3 ). Pain control choices are limited for individuals with spinal dysraphism, who undergo major urologic procedures ( 4 ). Viscomi et al ( 5 ) suggested spinal anesthesia for operations in patients with myelomeningocele.…”

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confidence: 99%

Caudal Anesthesia for Open Bladder Surgery in High-Risk Adolescent With Scoliosis and Neural Tube Defect

2015

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The efficacy of wound catheter infusion with local anesthetics for the treatment of postoperative pain in children: A systematic review

Swenker,

Dirckx,

Staals

2024

Paediatric and Neonatal Pain

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Wound catheter infusion (WCI) with local anesthetics (LA) is a regional anesthesia technique, which has shown to produce effective postoperative analgesia in adults, without any adverse effects on wound healing. To investigate the efficacy and safety of WCI with LA for the treatment of postoperative pain in children, we conducted a systematic review of literature published until 2020. The literature search included articles concerning subcutaneous WCI with LA, in the surgical wound, as treatment of postoperative pain, in children <18 years of age. Exclusion criteria were studies describing peripheral nerve blocks, intercostal, abdominal or thoracic wall blocks and single local anesthetic infiltration of the surgical wound. The articles were appraised for quality and only randomized controlled trials with a Jadad score ≥3 were included for evaluation of results concerning postoperative pain scores and opioid use. All relevant original studies, including observational studies and case reports, were assessed for adverse events and measurements of LA plasma concentrations during WCI. A total of 1907 articles were found, leading to 92 relevant abstracts selected for further review. After exclusion of articles of which full texts could not be retrieved or because of exclusion criteria, 28 articles remained. Thirteen articles described randomized controlled trials, of which 10 were assessed as good or excellent in quality. Due to the small number and heterogeneity of the studies, the data could not be pooled. Instead, results were described per type of procedure: abdominal surgery, extremity surgery, thoracic surgery and iliac crest bone harvesting. Reduced pain scores and opioid needs were demonstrated after abdominal and extremity surgery. In five studies, plasma levels of LA were measured, which all remained below toxic thresholds. In all relevant studies, no serious adverse events concerning the use of WCI were reported.

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How do I do it: Continuous local anesthetic infusion for children with spinal dysraphism undergoing major reconstruction of the lower urinary tract

Cited by 7 publications

References 5 publications

Ultrasound guided transversus abdominis plane block

Ultrasound guided transversus abdominis plane block

Caudal Anesthesia for Open Bladder Surgery in High-Risk Adolescent With Scoliosis and Neural Tube Defect

The efficacy of wound catheter infusion with local anesthetics for the treatment of postoperative pain in children: A systematic review

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