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Adjuvants in pediatric regional anesthesia
1Department of Anesthesiology & Pain Management, Faculty of Health Sciences, University of Washington, Seattle, USA and Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, USA. adrian.bosenberg@seattlechildrens.org.
Pain Management
|March 21, 2014
Summary
Local anesthetic adjuvants extend pain relief duration and enhance analgesia. Clonidine is increasingly popular, while ketamine use is limited due to neurotoxicity concerns.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Local anesthetics provide temporary pain relief.
- Adjuvants are crucial for prolonging anesthetic effects and improving pain management.
- Their use is expanding from neuraxial to peripheral nerve blocks.
Purpose of the Study:
- To review the utility and safety of various adjuvants used with local anesthetics.
- To compare adjuvants against morphine, the traditional standard.
- To highlight the growing importance of agents like clonidine.
Main Methods:
- Literature review of adjuvants used in regional anesthesia.
- Focus on neuraxial and peripheral nerve blocks, excluding intrathecal administration in children.
- Comparison of efficacy and side-effect profiles.
Main Results:
- Morphine is the benchmark for comparison.
- Clonidine demonstrates high utility and increasing popularity.
- Concerns regarding ketamine's neurotoxicity have led to its restricted use.
Conclusions:
- Adjuvants significantly enhance local anesthetic efficacy and duration.
- Clonidine is a valuable and increasingly utilized adjuvant.
- Careful consideration of side-effect profiles, such as ketamine's neurotoxicity, is essential for safe clinical practice.
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