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Regional Anesthesia for Neonates

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Neonatal Anesthesia

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Abstract

Regional anesthesia for neonates is technically challenging and should only be attempted by experienced providers. Anatomical, physiological, and pharmacological differences influence the choice of local anesthetic agent and type of block used. Ultrasound guidance, considered standard of practice in modern anesthesia, is particularly useful in neonates since the bone is more cartilaginous and allows greater penetration of ultrasound. Underlying anatomy, such as the spinal cord, can be easily visualized along its entire length. Peripheral nerves are superficial, and the anatomical relations can be seen in greater detail. The relative risks of regional anesthesia in neonates are greater than in older children, but overall the incidence of complications in neonates is low in experienced hands. Adjuvants and continuous infusions can be used to prolong the duration of the analgesia. Benefits of regional anesthesia in neonates are significant. Analgesia can be provided without the risks of opiate induced respiration depression.

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Authors and Affiliations

  1. Department Anesthesiology and Pain Management, Faculty Health Sciences, University Washington and Seattle Children’s Hospital, Seattle, WA, USA

    Adrian Bosenberg

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  1. Adrian Bosenberg
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Correspondence to Adrian Bosenberg .

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  1. Department of Anesthesia, John R. Oishei Children’s Hospitalr, Buffalo, NY, USA

    Jerrold Lerman

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Bosenberg, A. (2023). Regional Anesthesia for Neonates. In: Lerman, J. (eds) Neonatal Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-031-25358-4_16

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