Pediatric regional anesthesia and acute pain management: State of the art

IF 4.7 3区 医学 Q1 ANESTHESIOLOGY Best Practice & Research-Clinical Anaesthesiology Pub Date : 2024-06-01 DOI:10.1016/j.bpa.2024.05.003
Natalie R. Barnett , John G. Hagen , Deepa Kattail
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Abstract

Pediatric regional anesthesia has been in existence for over 125 years, but significant progress and widespread use has occurred in the last few decades, with the increasing availability of ultrasound guidance. Evidence supporting the safety of regional anesthesia when performed under general anesthesia has also allowed the field to flourish. Newer techniques allow for more precise nerve blockade and in general this has resulted in more peripheral blocks replacing central blocks, such as caudal epidurals and spinal anesthesia. Current controversial topics in the field include the method of obtaining loss of resistance when placing epidural catheters, the role of regional anesthesia in compartment syndrome and post-hypospadias repair complications, and utility of test doses.

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小儿区域麻醉和急性疼痛管理:最新技术
小儿区域麻醉已有超过 125 年的历史,但随着超声引导技术的日益普及,在过去几十年中取得了重大进展并得到了广泛应用。有证据表明,在全身麻醉的情况下进行区域麻醉是安全的,这也使这一领域得以蓬勃发展。较新的技术可实现更精确的神经阻滞,总体而言,这使得更多的外周阻滞取代了中枢阻滞,如尾部硬膜外麻醉和脊髓麻醉。目前该领域存在争议的话题包括:放置硬膜外导管时获得阻力消失的方法、区域麻醉在室间隔综合征和膀胱尿道修补术后并发症中的作用以及测试剂量的效用。
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审稿时长
36 days
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