Peripheral Nerve Block Complications in Children

Catalani, Blas; Jones, Jerry W.

doi:10.1016/j.ocl.2021.11.004

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…Peripheral neural blocks (PNBs) allow the delivery of anesthetic along or close to the specific peripheral nerve of the target body part ( 46 ). The data from reports prove the efficiency and versatility of peripheral nerve blocks.…”

Section: Resultsmentioning

confidence: 99%

Regional anesthesia for pain control in children with solid tumors—a review of case reports

Baizhanova,

Zhailauova,

Sazonov

2024

Front. Pediatr.

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IntroductionAround seventy percent of all childhood cancer patients suffer from severe pain. This pain can arise from various sources, including tumors themselves, pain caused by metastasizing tumor cells or as the outcome of therapy meant to deal with tumors. If managed inadequately, such pain can lead to many hazardous sequelae. However, there are extreme cases when pain does not respond to standard treatment. For such cases, regional anesthesia or nerve blocks are utilized as the utmost pain control measure. Blocks are used to treat pain in patients who no longer respond to conventional opioid-based treatment or whose worsened condition makes it impossible to receive any other therapy. The data regarding the use of regional anesthesia for such cases in the children population is limited.MethodsFor this review we searched for case reports in Scopus and PubMed from inception to 2023. The descriptive search items included terms related to childhood cancer and the description of each block. The inclusion criteria for review include children (0-18 years old) receiving oncology-related surgical procedures or palliative care. The data collection was limited to solid tumor-related cases only. We analyzed a total of 38 studies that included case reports and one retrospective study.Results and discussionIt was concluded that nerve blocks, although rarely performed, are a safe and efficient way of pain control in children with solid tumors. The major settings for block performance are postoperative pain control and palliative care. We observed that block indication and its outcomes depend on unique health circumstances in which they should be performed. Patients with similar diagnoses had differing outcomes while receiving the same block treatment.

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Section: Resultsmentioning

confidence: 99%

Regional anesthesia for pain control in children with solid tumors—a review of case reports

Baizhanova,

Zhailauova,

Sazonov

2024

Front. Pediatr.

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“…When performing regional anesthesia in pediatric populations, amino-amide class local anesthetics are preferred due to the prolonged duration of action. 57 Since a long-acting analgesic is preferred in an MNB, ropivacaine or (levo)bupivacaine are the most frequently described analgesics for MNB administration with regard to cleft surgery. 2 , 5 , 11 , 20 – 22 In the survey, the reported concentration of 3% ropivacaine (n=1) is much higher than the maximum concentration of 1% available on the market.…”

Section: Discussionmentioning

confidence: 99%

The Maxillary Nerve Block in Cleft Palate Care: A Review of the Literature and Expert’s Opinion on the Preferred Technique of Administration

Peters,

Jacobs,

Munill

et al. 2024

Journal of Craniofacial Surgery

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Introduction: Although the maxillary nerve block (MNB) provides adequate pain relief in cleft palate surgery, it is not routinely used globally, and reported techniques are heterogeneous. This study aims to describe relevant anatomy and to present the preferred technique of MNB administration based on the current literature and the expert opinion of the authors. Method and materials: First, a survey was sent to 432 registrants of the International Cleft Palate Master Course Amsterdam 2023. Second, MEDLINE (PubMed interface) was searched for relevant literature on maxillary artery (MA) anatomy and MNB administration in pediatric patients. Results: Survey response rate was 18% (n=78). Thirty-five respondents (44.9%) used MNB for cleft palate surgery before the course. A suprazygomatic approach with needle reorientation towards the ipsilateral commissure before incision was most frequently reported, mostly without the use of ultrasound. Ten and 20 articles were included on, respectively, MA anatomy and MNB administration. A 47.5% to 69.4% of the MA’s run superficial to the lateral pterygoid muscle and 32% to 52.5% medially. The most frequently described technique for MNB administration is the suprazygomatic approach. Reorientation of the needle towards the anterior aspect of the contralateral tragus appears optimal. Needle reorientation angles do not have to be adjusted for age, unlike needle depth. The preferred anesthetics are either ropivacaine or (levo)bupivacaine, with dexmedetomidine as an adjuvant. Conclusion: Described MNB techniques are heterogeneous throughout the literature and among survey respondents and not routinely used. Further research is required comparing different techniques regarding efficacy and safety.

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“…Both the safety and efficacy of caudal analgesia and PNBs as adjuvants to general anesthesia in the pediatric population were documented in multiple studies, with the advantage of reducing perioperative anesthetic consumption with longer and more effective postoperative analgesia (9,10,(16)(17)(18). Furthermore, the use of US guidance has facilitated the procedure and minimized the incidence of complications (11)(12)(13)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

“…The caudal block is widely used as an adjunct to general anesthesia in pediatric patients and has been proven to decrease intraoperative anesthetic demands with adequate perioperative pain control (9,10). The use of peripheral nerve blocks (PNB) in pediatric patients has gained popularity after the incorporation of ultrasound (US) techniques in regional anesthesia practice, with higher rates of successful blocks, using lower doses of local anesthetics, and fewer complications (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Sciatic Nerve Block vs. Caudal Analgesia in Cerebral Palsy Undergoing Lower Limb Surgeries

Fahim,

Mahrose,

Kasem

et al. 2023

Anesth Pain Med

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Background: Continuous advancements in ultrasound (US)-guided neuraxial and peripheral nerve blocks (PNB) have allowed the safe and successful use of these blocks as adjuvants to general anesthesia in pediatric patients. Objectives: This study was designed to compare the analgesic efficacy of 2 US-guided regional techniques, caudal epidural block (CEB) and subgluteal sciatic nerve block (SNB), in children with cerebral palsy (CP). Methods: The current randomized comparative study was conducted on 30 patients with spastic CP aged 2-12 years who were scheduled for unilateral lower limb multilevel soft tissue corrective surgeries, randomly distributed using a computerized program into 2 equal groups. The CEB group received a US-guided caudal block, and the SNB group received a US subgluteal sciatic nerve block. The time to the first postoperative analgesia requirement (primary outcome), postoperative pain score, total postoperative analgesic consumption, and perioperative complications (secondary outcomes) were assessed in both groups. Results: The duration of postoperative analgesia was significantly longer in patients of the SNB (14.65 ± 3.08 h) than in the CEB group (5.93 ± 1.68 h). The postoperative pain scores recorded at 6th-12th h and the postoperative 24-h rescue analgesic consumption were significantly lower in the SNB compared to the CEB group. Conclusions: Ultrasound-guided subgluteal sciatic nerve block is a safe and effective alternative to US-guided caudal analgesia in pediatric patients with spastic CP scheduled for lower limb surgeries, with longer postoperative analgesia and similar perioperative safety profiles.

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Peripheral Nerve Block Complications in Children

Cited by 8 publications

References 14 publications

Regional anesthesia for pain control in children with solid tumors—a review of case reports

Regional anesthesia for pain control in children with solid tumors—a review of case reports

The Maxillary Nerve Block in Cleft Palate Care: A Review of the Literature and Expert’s Opinion on the Preferred Technique of Administration

Ultrasound-Guided Sciatic Nerve Block vs. Caudal Analgesia in Cerebral Palsy Undergoing Lower Limb Surgeries

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