New blocks on the kids
Core basic nerve blocks in paediatric anaesthesia
Anaesthesia
Submitted January 2023 by Dr Derek Rosen
Read by 273 Journal Watch subscribers
This useful review article discusses the benefits of regional anaesthesia in children (anaesthesia sparing, opioid sparing, and a reduction in emergence delirium severity) despite its lower use compared with adult anaesthesia and highlights seven high value nerve blocks which should become core competencies. The proposed ‘plan A blocks’ are:
• Axillary
• Femoral
• Popliteal sciatic
• Rectus sheath
• Lateral quadratus lumborum
• Caudal
• Dorsal penile nerve
These blocks have a good safety profile and can be employed in common paediatric surgeries. The authors advocate for ultrasound use, catheter use and highlight that performing blocks in anaesthetised children carries no increased risk of nerve injury.