Mathew Ashley, Kerolus Katrina, Bitonti Nicholas, Guzman Andrea, Moore Robert, Bergese Sergio
Department of Anesthesiology, Stony Brook University Health Science Center, Stony Brook, NY 11794, USA.
Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
J Clin Med. 2024 Nov 8;13(22):6704. doi: 10.3390/jcm13226704.
Pediatric regional anesthesia is evolving with new peripheral nerve blocks and techniques aimed at improving perioperative pain management. While caudal blocks have long been standard due to their simplicity and low complication rates, newer fascial plane blocks offer comparable efficacy with enhanced nerve coverage tailored to specific surgeries. Moreover, adjuncts like dexmedetomidine and dexamethasone have shown promise in prolonging block duration and enhancing post-operative pain relief and patient satisfaction. The integration of these advancements into clinical practice has yielded significant benefits, including reduced intraoperative fluid requirements, decreased reliance on opioids postoperatively, earlier initiation of enteral nutrition, lower readmission rates, shorter hospital stays, and decreased overall hospital costs. Our review underscores the technical progress and expanding literature supporting the rapid adoption of these impactful regional anesthesia techniques in pediatric care.
小儿区域麻醉正在随着旨在改善围手术期疼痛管理的新的外周神经阻滞和技术而不断发展。虽然由于其操作简单和并发症发生率低，骶管阻滞长期以来一直是标准方法，但更新的筋膜平面阻滞在针对特定手术提供增强的神经覆盖方面具有相当的疗效。此外，右美托咪定和地塞米松等辅助药物在延长阻滞持续时间、增强术后疼痛缓解和提高患者满意度方面已显示出前景。将这些进展整合到临床实践中已产生了显著益处，包括减少术中液体需求、降低术后对阿片类药物的依赖、更早开始肠内营养、降低再入院率、缩短住院时间以及降低总体医院成本。我们的综述强调了技术进步以及越来越多的文献支持在儿科护理中迅速采用这些有影响力的区域麻醉技术。
