Advertisement

Epidural and Regional Anesthesia

  • Arjunan Ganesh
  • John B. Rose
Chapter

Abstract

Children undergoing surgical procedures benefit from many improvements in pain management that have occurred over the past few decades. These enhancements are the result of changes in the attitudes of physicians, nurses, hospital administrators, and patients and their families, coupled with increased pressure from external regulatory agencies ­mandating the adequate assessment and effective treatment of pain in children. It can no longer be debated that infants and children have the capacity to feel pain, or that the experience of pain by a child potentially results in negative short- and long-term consequences. In fact, the evidence continues to mount that inadequately treated pain in children can result in harmful physiological and behavioral consequences and delay ­recovery from surgical procedures as measured by time required to return to a regular diet, activity, and hospital discharge.

Keywords

Epidural Catheter Epidural Space Rectus Sheath Intrathecal Morphine Epidural Infusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

General

  1. Fitzgerals M, Howard R. The neurobiologic basis of pediatric pain. In: Schechter NL, Berde CB, Yaster M, editors. Pain in infants, children, and adolescents. 2nd ed. Baltimore: Lippincott William & Wilkins; 2001. p. 19–42.Google Scholar
  2. Lidow MS. Long-term effects of neonatal pain on nociceptive systems. Pain. 2002;99(3):377–83.CrossRefPubMedGoogle Scholar
  3. Taddio A, Katz J, Ilevsick AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet. 1997;349:599–603.CrossRefPubMedGoogle Scholar
  4. Weisman SJ, Bernstein B, Schechter NL. Consequences of inadequate analgesia during painful procedures in children. Arch Pediatr Adolesc Med. 1998;152:147–9.PubMedGoogle Scholar

Epidural

  1. Birmingham DK, Wheeler M, Suresh S, Dsida RM, Rae BR, Obrecht J, et al. Patient-controlled epidural analgesia in children: can they do it? Anesth Analg. 2003;96(3):686–91.PubMedGoogle Scholar
  2. Krane EJ, Dalens BJ, Murat I, et al. The safety of epidurals placed during general anesthesia. Reg Anesth Pain Med. 1998;23:433–8.CrossRefPubMedGoogle Scholar
  3. Meunier JF, Goujard E, Dubuousset AM, Samii K, Mazoit JX. Pharmacokinetics of bupivacaine after continuous epidural infusions in infants with and without biliary atresia. Anesthesiology. 2001;95(1):87–95.CrossRefPubMedGoogle Scholar
  4. Tsui BC, Wagner A, Cave D, Kearney R. Thoracic and lumbar epidural analgesia via the caudal approach using electrical stimulation guidance in pediatric patients: a review of 289 patients. Anesthesiology. 2004;100(3):683–9.CrossRefPubMedGoogle Scholar

Other Regional

  1. Berde CB. Regional anesthesia in children: what have we learned? Anesth Analg. 1996;83(5):897–900.CrossRefPubMedGoogle Scholar
  2. Darbure C, Pirot P, Raux O, Troncin R, Rochette A, Ricard C, et al. Perioperative continuous peripheral nerve blocks with disposable infusion pump in children: a prospective descriptive study. Anesth Analg. 2003;97(3):687–90.Google Scholar
  3. Hadzik A, Vloka J. Neurologic complications of peripheral nerve block. In: Hadzik A, Vloka J, editors. New York School of Regional Anesthesia: peripheral nerve blocks: principles and practice. New York: McGraw-Hill; 2004. p. 67–77.Google Scholar
  4. Marhofer P, Greher M, Kapral S. Ultrasound guidance in regional anaesthesia. Br J Anaesth. 2005;94(1):7–17.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of Pennsylvania, Children’s Hospital of PhiladelphiaPhiladelphiaUSA

Personalised recommendations