Regional anaesthetic techniques for paediatric surgery

Peripheral nerves blocks provide intra- and postoperative analgesia and are an important element of the multimodal approach to perioperative pain. This is particularly important in the paediatric population, where the side effects of opioids, such as respiratory depression, postoperative nausea and vomiting (PONV), and gastrointestinal motility issues, can be especially challenging. The addition of a block to the multimodal strategy allows in most situations for a significant dose reduction in opioid requirements and in some cases to a complete avoidance of opioids. In addition to this, the faster recovery times, the early discharge, and the shift to performing more procedures in day case have led to an increased popularity of using regional blocks in children. This article aims to discuss current practices, benefits and challenges associated with nerve blocks in children and offers a general approach to performing common ultrasound-guided regional techniques in the paediatric population.