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Nursing Management of Children With Peripheral Nerve Blocks
Jamie Reddinger1, Alexander Praslick1, Kara Halteman1
1Children's Hospital of Pittsburgh of UPMC, Department of Anesthesiology, Pittsburgh, PA.
Insights
Pediatric nurses need updated guidance on peripheral nerve blocks (PNBs) for postoperative pain management. This review synthesizes essential nursing care components for PNBs, improving pediatric patient outcomes.
Area of Science:
- Nursing
- Anesthesiology
- Pediatric Surgery
Background:
- Peripheral nerve blocks (PNBs) are increasingly used for postoperative pain management in pediatric surgery.
- A knowledge gap exists in nursing literature regarding PNB care for pediatric patients.
- Nurses play a vital role in optimizing pain management and patient safety.
Purpose of the Study:
- To provide pediatric surgical nurses with essential knowledge for postoperative care of pediatric patients receiving PNBs.
- To cover indications, analgesia targets, local anesthetics, complications, and nursing care aspects of PNBs.
- To bridge the gap in nursing literature concerning PNB management in pediatric surgical settings.
Main Methods:
- A comprehensive literature review of evidence-based practice articles on pediatric regional anesthesia and PNBs.
- Searched databases including PubMed, CINAHL, Ovid, and the University of Pittsburgh Health Sciences Library.
- Reviewed clinical guidelines from major pain and anesthesia societies for best practices.
Main Results:
- Identified core components of nursing management for PNBs.
- Key considerations include understanding local anesthetic pharmacology, infusion pump/catheter care, site assessment, pain evaluation, and neurovascular monitoring.
- Emphasized the importance of early complication identification and patient/family education.
Conclusions:
- Literature and guidelines highlight essential components for evidence-based nursing care of pediatric PNBs.
- Enhanced knowledge of PNBs improves nursing management, patient comfort, and safety.
- This synthesis supports informed practice for better clinical outcomes in pediatric surgical pain management.
Purpose:
Currently, there is a notable gap in the nursing literature addressing guidance for the care of pediatric surgical patients receiving peripheral nerve blocks (PNBs). This article aims to bridge that gap by equipping pediatric surgical nurses with essential knowledge on the postoperative care of pediatric patients receiving PNBs, including indications for use, targeted areas of analgesia, common local anesthesia medications, potential complications, and key aspects of nursing care.
Methods:
A comprehensive literature review was conducted to locate current evidence-based practice articles on pediatric regional anesthesia in the category of PNBs. Databases searched included PubMed, CINAHL, Ovid, and the University of Pittsburgh Health Sciences Library System. Key words included in the search were pediatric peripheral nerve block, pediatric regional anesthesia, peripheral nerve block complications, nursing care peripheral nerve block, and nursing care regional anesthesia. The clinical guidelines on the management of postoperative pain from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists was reviewed to ensure best practices.
Results:
Drawing from the evidence base, core components of nursing management were identified. Primary considerations include understanding the pharmacology of local anesthetics, proper care of infusion pumps and catheters, assessment of the insertion site, comprehensive pain evaluation, sensory and motor function monitoring, early identification of complications, and family and patient education.
Conclusion:
A review of the literature and professional guidelines highlighted the essential components of nursing care. This information supported the development of informed, evidence-based practices contained within this manuscript.
Clinical Implications:
Nurses are critical in providing high-quality patient care, particularly with respect to pain management in pediatric surgical settings. With the increasing use of regional anesthesia for postoperative pain management, it is essential for nursing staff to have a comprehensive understanding of its benefits and applications. Enhancing pediatric surgical nurses' knowledge of PNBs ensures proper management, optimizes patient comfort and safety, and contributes to improved clinical outcomes.
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