Paediatric anaesthesia
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The use of regional anesthesia is increasingly common in pediatric practice. This review reports the complications and risks in pediatric regional anesthesia. ⋯ However, the different studies have shown that regional anesthesia, when performed properly, carried a very low risk of morbidity in appropriately selected infants and children. In addition, the use of ultrasound-guided peripheral nerve blockade has shown some promise toward increasing the safety profile of these already safe techniques.
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Paediatric anaesthesia · Jan 2012
ReviewQuality assurance and improvement: the Pediatric Regional Anesthesia Network.
Quality assurance and improvement (QA/QI) is a critical activity in medicine. The use of large-scale collaborative databases is increasingly essential to obtain enough reports with which to establish standards of practice and define the incidence of complications and risk/benefit ratios for rare events. ⋯ The pediatric regional anesthesia network (PRAN) is such a project. The first data cohort is currently being analyzed and offers insight into how such data can be used to detect trends in adverse events and improve care.
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The introduction of nerve stimulation as a method of nerve localization sparked a new beginning in regional anesthesia. It was an epochal development akin to the utilization of ultrasound in more recent times. ⋯ Both of these technologies allow for only limited elucidation of needle position relative to the target nerve and are unable to reliably identify intraneural position of the needle. This article will review the role of nerve stimulation in modern regional anesthesia techniques in light of the introduction of ultrasound technology.
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The pediatric epidural is an accepted method of advanced analgesia in children. Newer techniques have now superseded pediatric epidural analgesia (PEA), being as effective and safer, especially with the advances in ultrasonography. PEA is, however, still an important technique to master and employ, and it may be that the indications for this mode of analgesia have now become more defined.