Cahiers d'anesthésiologie
-
Caudal block is the most frequently epidural block performed in children. A better knowledge of the child anatomy, physiology and pharmacokinetics has increased the safety of regional anaesthesia in children. ⋯ The children, as well as adult, have benefited of new drugs (opioids, alpha 2 agonists) which increase the indications regarding time duration or pain intensity. If complications are still possible the respect of safety rules and the use of adapted equipment make caudal block a safe regional anaesthesia.
-
This article will briefly review the techniques of epidural anaesthesia via lumbar and sacral routes, as well as the indications and contraindications of the techniques. Guidelines for per- and postoperative use of epidural anaesthesia are provided.
-
Regional anaesthesia is more and more popular in pediatrics. Many arguments plead for its use. ⋯ So is the quality of intra- and postoperative analgesia. In addition, the few number of complications is also an advantage of regional blocks in children.
-
Wound infiltration with a local anaesthetic may be used either to provide anaesthesia for superficial surgery or for postoperative pain relief. In the latter situation, its efficacy is real but remains moderate and usually requires a combination with other analgesics. Ilio-iguinal and ilio-hypogastric block has been shown to have an analgesic efficacy close to that obtained with a wound infiltration but the duration of analgesia may be longer. These blocks remain unfrequently used in adults.