8 Paediatric regional anaesthesia: an update

Abstract

Regional anaesthetic techniques and the agents used for their administration have come a long way since 1986. It is now possible to perform a regional block for every surgical procedure in the paediatric repertoire and, if necessary, keep it running well into the post-operative period. We should be aware of the pitfalls of the various techniques from the audits of Dalens and Chrysostome (1991), Wilson and Lloyd-Thomas (1993), Wood et al (1994), Flandin-Bety and Barrier (1995) and Stafford et al (1995). Experts such as Berde, Eyres and Murat have shared the experience of their practice in Boston, Melbourne and Paris with us, and individual colleagues have alerted us to the unexpected problems which have arisen in their daily practice. There will still be reports of the unexpected and bizarre in years to come. Compared to adult practice, paediatric regional anaesthesia is still in its infancy and dependent on studies performed on small groups of children.

It is no disgrace to accept that regional techniques are more difficult to perform in children, and there is nothing to be gained by opting for the most difficult when a safer, adequate technique will suffice.