新生儿和婴儿区域阻滞的专家提示。

Anesthesia and pain medicine Pub Date : 2024-10-01 Epub Date: 2024-07-29 DOI:10.17085/apm.23164
Vrushali Chandrashekhar Ponde, Amrita Rath, Neha Singh
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引用次数: 0

摘要

小儿区域麻醉(RA)已成为小儿麻醉中发展迅速的一个领域,需要不断地获取知识。这篇综述强调了这一专科的当代意义,重点是其在新生儿和婴儿中的应用。RA 的主要目的是在有效解决围术期疼痛的同时保持微妙的生理平衡,从而提高对患者的整体护理。本综述探讨了 RA 在这一年龄组中的优势。此外,还通过探讨传统和最新引入的 RA 技术的优缺点,对这些方法进行了研究。目的是让临床医生对这些方法在不同临床情况下的适用性有一个细致入微的了解。此外,本综述还阐明了与小儿 RA 相关的独特考虑因素,承认小儿患者具有独特的解剖和生理特点。还考虑了先天性异常的特殊病例及其对选择 RA 的影响。该综述的一个重点是新生儿和婴儿的局麻药剂量和各种阻滞所需的容量。还考虑了持续输注的剂量和输注的实际问题。还介绍了 RA 引起的并发症及其预防和治疗方法。这篇综述为各种区域阻滞的选择标准提供了实用的见解,有助于麻醉医生根据患者的不同需求做出明智的决定。
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Expert's tips on regional blocks in neonates and infants.

Pediatric regional anesthesia (RA) has emerged as a rapidly advancing dimension within pediatric anesthesia, demanding a continual commitment to knowledge acquisition. This review underscores the contemporary significance of this specialty, focusing on its application in neonates and infants. The primary objective of RA is to address perioperative pain effectively while preserving the delicate physiological balance, thereby enhancing overall patient care. This review explores the advantages offered by RA in this age group. Furthermore, conventional, and recently introduced techniques of RA are examined by exploring the advantages and disadvantages of these methods. The aim is to provide clinicians with a nuanced understanding of their applicability in different clinical scenarios. Additionally, the review elucidates the unique considerations associated with pediatric RA, acknowledging pediatric patients' distinctive anatomical and physiological characteristics. The exceptional cases of congenital anomalies and their implications for the choice of RA are considered. An aspect of the review is its focus on dosages of local anesthetics and the volumes required for various blocks in neonates and infants. The dosages for continuous infusion and practical issues with infusions are considered. Complications due to RA are described with their prevention and treatment. The review offers pragmatic insights into the selection criteria for various regional blocks, aiding anesthesiologists in making informed decisions tailored to individual patient needs.

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