tailieunhanh - Ultrasound imaging for pediatric anesthesia: A review

This chapter will review a variety of common peripheral nerve and central neuraxial blocks that can be performed using ultrasound guidance in children. This aspect of regional anesthesia has the potential for significant contributions to evidence-based medicine. | 11 Ultrasound Imaging for Pediatric Anesthesia A Review Santhanam Suresh MD Lauren J Taylor BA and Amar S. Minhas Department of Pediatric Anesthesiology Children s Memorial Hospital Northwestern University Feinberg School of Medicine Chicago IL USA 1. Introduction There has been a recent increase in the use of regional anesthesia in pediatric patients Lacroix 2008 . This explosive growth particularly in the use of truncal blocks can be attributed in part to the refinement of anatomically based ultrasound imaging to facilitate nerve localization. Historically pediatric regional anesthesia has posed a significant challenge due to the close proximity of nerves to critical structures and the need for limiting the local anesthetic volume below toxic levels in children. Ultrasound guidance however allow s the visualization of important anatomy and can help overcome many of these traditional obstacles. This chapter will review a variety of common peripheral nerve and central neuraxial blocks that can be performed using ultrasound guidance in children. This aspect of regional anesthesia has the potential for significant contributions to evidence-based medicine. Because ultrasound guidance is a relative newcomer to the field of regional anesthesia most of the current literature is not evidence based. As a result much of the data comes from case reports and case series. This chapter is based on an extensive review of the literature using MEDLINE and EMBASE from 1980 to May 28 2009. Our goal is to provide the pediatric anesthesiologist with a comprehensive summary of the relevant sonoanatomy techniques and outcomes of ultrasound guidance for peripheral nerve blocks of the extremities and trunk as well as neuraxial blocks in pediatric patients based on currently available literature. 2. Peripheral nerve blocks Upper extremity blocks Peripheral regional anesthesia is of great utility in children undergoing surgery on the upper extremities. Although many approaches to the .