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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

355
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
355
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

386
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

576
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
576

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Long-term Complications From Peripheral Nerve Blocks After Pediatric Orthopaedic Lower Extremity Procedures: A

Sunny M Trivedi1,2, Charlotte F Wahle3,2, Yifan V Mao3,2

  • 1Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, California, USA.

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Peripheral nerve blocks (PNBs) are common in pediatric orthopaedic surgery. While rare, long-term complications like chronic pain and motor deficits can occur after lower extremity procedures.

Keywords:
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Area of Science:

  • Anesthesiology
  • Pediatric Orthopaedics
  • Regional Anesthesia

Background:

  • Peripheral nerve blocks (PNBs) are widely used for pediatric orthopaedic surgery.
  • PNBs aid in postoperative pain management and faster discharge.
  • Long-term complication rates after PNBs in children are not well-established.

Purpose of the Study:

  • To determine the frequency of long-term complications in pediatric patients.
  • Focus on patients undergoing lower extremity orthopaedic procedures with regional anesthesia.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Searched literature for studies reporting long-term complications (≥6 weeks) after PNBs in pediatric patients.
  • Included data on block type, location, procedure, patient age, and outcomes.

Main Results:

  • 16 of 158 studies (10%) discussed long-term complications.
  • 9 studies reported complications, 7 reported none.
  • Common complications included motor deficits (10%), reduced range of motion (12%), chronic pain (5%), and sensory deficits (0.07%).

Conclusions:

  • Persistent complications can occur in pediatric patients receiving PNBs for lower extremity orthopaedic surgery.
  • However, the reported incidence of these long-term issues in the literature is infrequent.