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Regional Anesthesia in Patients with Cerebral Palsy

  • Kesavan Sadacharam
  • Robert P. Brislin
  • R. Scott Lang
Living reference work entry

Abstract

Pain management in patients with cerebral palsy is often complex due to coexisting medical CONDITIONS, which MAKE them vulnerable to the side effects of the opioid-based pain management. In this instance, regional anesthesia can be used to improve the quality of analgesia and help to minimize the need for administration of opioids. Traditionally, epidural and caudal anesthesia are the most common regional anesthesia techniques used in patients with cerebral palsy. However, peripheral nerve blocks have become popular in the last decade due to favorable evidence to improve the quality of analgesia in children undergoing orthopedic procedures. The compelling evidence in favor of the use of peripheral regional nerve blocks in the general pediatric population argues strongly for its inclusion in the pain management of children with cerebral palsy. This chapter discusses the various options of regional procedure for common orthopedic procedures in patients with cerebral palsy and illustrates each nerve block in detail. Further, we DESCRIBE THE feasibility of performing regional nerve blocks in challenging SITUATIONS such as in patients with spinal instrumentation and baclofen catheter in situ.

Keywords

Caudal epidural Lumbar epidural Peripheral nerve block Brachial plexus block Femoral nerve block 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Kesavan Sadacharam
    • 1
  • Robert P. Brislin
    • 1
  • R. Scott Lang
    • 1
  1. 1.Division of Surgical Anesthesiology, Department of Anesthesiology & Perioperative MedicineNemours/Alfred I. duPont Hospital for ChildrenWilmingtonUSA

Section editors and affiliations

  • Freeman Miller
    • 1
  1. 1.AI DuPont Hospital for ChildrenWilmingtonUSA

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