ULTRASOUND-GUIDED REGIONAL ANESTHESIA IN PEDIATRIC POPULATION WITH FOCUS ON UPPER EXTREMITY NERVE BLOCKS

Abstract

Postoperative pain management in children is quite challenging. There are numerous benefits from regional anesthesia as a part of multimodal anesthesia protocols, while failure to achieve postoperative pain control in children can cause delay in physical healing and psychological effects in the long term, such as sleep disorders, anxiety, and chronic pain. Anatomical, physiological, and pharmacological differences between adults and the pediatric population should be understood before performing regional anesthesia in children.

In the past two decades, relying on ultrasound guidance, the regional anesthesia in pediatric patients of any age has seen significant development and evolved to the point of setting a new standard. This review is based on studies, guidelines, and peer-reviewed articles focusing on pediatric regional anesthesia in current literature. This review includes descriptions and illustrations of the relevant sonoanatomy of brachial plexus on different levels, ultrasound probe positioning, surgical indications, and associated potential complications. The aim of this review hopefully, is to serve as a foundation for a better understanding of the block techniques of the upper extremity, with their clinical indications, as well as to facilitate improved perioperative pain management in children.