Changing trends in paediatric regional anaesthetic practice in recent years

Regional anaesthesia has come to a substantial position in paediatric anaesthesia. Time has now come to assess what has reached significant acceptance in daily practice and try to clear possible ways up for the next steps to come.

Epidemiologic data produced in the last 2 years provide useful information about the place taken by regional anaesthesia as a whole and by the most popular blocks nowadays. Significant series seem to open a track in the field of postoperative pain management at home. Ultrasound guidance takes a great part in recent publications. The most relevant, according to the location of blocks and in the scope of security, are presented. Change in anatomical background that ultrasonography demands is questioned. Finally, most recently described approaches and their potential advantages have been looked at.

Lessons can be drawn from epidemiologic data now available and possible ways for changes in a near future can be anticipated. Ultrasonology brings clear advantages in abdominal wall blocks. Its use in place of nerve stimulation is claimed forcefully but not yet widely used for the blocks of the limbs in children. This switch requires profound changes in the practice of regional anaesthesia which will probably not take place immediately. Blocks of the face appear innovating and promising, according to recent literature.