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Unique Issues Related to Regional Anesthesia in Pediatric Orthopedics
Walid Alrayashi1, Joseph Cravero2, Roland Brusseau3
1Department of Anesthesiology, Harvard Medical School, Home Analgesia Program, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
This article discusses key issues in pediatric regional anesthesia, including awake versus anesthetized blocks, orthopedic risks like compartment syndrome, and concerns with instrumented spine procedures. It also highlights the growing use of ambulatory regional catheters in pediatric orthopedic anesthesia.
Area of Science:
- Pediatric Anesthesiology
- Regional Anesthesia Techniques
Background:
- Regional anesthesia is crucial in pediatric care.
- Specific challenges exist in pediatric regional anesthesia applications.
Purpose of the Study:
- To review significant issues in pediatric regional anesthesia.
- To discuss the evolving role of ambulatory regional catheters.
Main Methods:
- Literature review and synthesis of current practices.
- Discussion of controversies and risks associated with specific procedures.
Main Results:
- Addresses the awake vs. anesthetized block placement debate.
- Examines risks of compartment syndrome in orthopedic cases.
- Reviews implications of regional anesthetics with instrumented spines.
- Highlights the utility of ambulatory catheters in pediatric orthopedic anesthesia, especially during the COVID-19 pandemic.
Conclusions:
- Regional anesthesia in pediatrics requires careful consideration of specific patient populations and procedures.
- Ambulatory regional catheters offer a valuable option for outpatient pediatric orthopedic surgery.
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