Per-Arne Lönnqvist1, Claude Ecoffey, Adrian Bosenberg, Santhanam Suresh, Giorgio Ivani. 1. aSection of Anaesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, Paediatric Anaesthesia/PICU/ECMO Services, Karolinska University Hospital, Stockholm, Sweden bPôle Anesthésie-SAMU-Urgences-Réanimations, Hôpital Pontchaillou, Université Rennes 1, Rennes, France cSeattle Children's Hospital, University of Washington, Seattle, Washington dAnn & Robert H. Lurie Children's Hospital of Chicago, Chicago; Northwestern University, Evanston, Illinois, USA eDepartment of Anesthesiology, Regina Margherita Children's Hospital, Turin, Italy.
Abstract
PURPOSE OF REVIEW: To summarize the two recent sets of European and American Societies of Regional Anesthesia (ESRA-ASRA) Practice Advisory Guidelines for the performance of pediatric regional anesthesia (PRA). RECENT FINDINGS: Owing to the still ongoing debate regarding crucial issues concerning the effective and safe conduct of PRA and because of the lack of any generally accepted guidelines regarding PRA the (ESRA-ASRA) have addressed these in two topical publications. SUMMARY: Following an extensive literature search and an evidence-based approach the ESRA-ASRA task force have now provided a practice advisory on the following hot topics in PRA: the safety and appropriateness of placing block during general anesthesia or deep sedation, the use of test dosing, whether to use air or saline when performing loss-of-resistance, the risk of masking an acute compartment syndrome by use of PRA, dosing of local anesthetics for neuroaxial nerve blocks as well as peripheral nerve blocks, and finally the use of various drugs as adjuncts to local anesthetics.
PURPOSE OF REVIEW: To summarize the two recent sets of European and American Societies of Regional Anesthesia (ESRA-ASRA) Practice Advisory Guidelines for the performance of pediatric regional anesthesia (PRA). RECENT FINDINGS: Owing to the still ongoing debate regarding crucial issues concerning the effective and safe conduct of PRA and because of the lack of any generally accepted guidelines regarding PRA the (ESRA-ASRA) have addressed these in two topical publications. SUMMARY: Following an extensive literature search and an evidence-based approach the ESRA-ASRA task force have now provided a practice advisory on the following hot topics in PRA: the safety and appropriateness of placing block during general anesthesia or deep sedation, the use of test dosing, whether to use air or saline when performing loss-of-resistance, the risk of masking an acute compartment syndrome by use of PRA, dosing of local anesthetics for neuroaxial nerve blocks as well as peripheral nerve blocks, and finally the use of various drugs as adjuncts to local anesthetics.
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