Pediatric regional Anesthesia

Abstract

Dating back to the ancient Egypt 2500 BC, the use of regional anesthesia was emphasized for circumcision. Traditional Chinese medicine has taught the use of needles and acupuncture for pain management for centuries. August Bier reported in 1899 the first study on the use of regional anesthesia in children. This was followed by a report by Bainbridge on the use of spinal anesthesia in children. The use of caudal analgesia in children was described in the urology literature in the early 30's (Suresh and Ivani, 2006). The last decades have had numerous studies that have demonstrated the need for analgesia in newborn children and infants (Anand et al., 1987). This resulted in significant changes and advancements in clinical anesthesia care for infants, children and adolescents. In particular, the decrease in stress has resulted in better outcomes in infants and children. Infants exposed to significant pain in the neonatal period may experience bio-behavioral changes with advancing age. This led the medical professionals to consider the use of adequate analgesia in infants. Although the usual dictum that 'children are just small adults' may be applied towards regional analgesia

use in the adolescent population, it is much less applicable to infants and toddlers (Taddio et al., 1997). Pediatric regional anesthesia has gone through significant development in

recent years with advances in safety information, pharmacology, and block techniques. There is an increasing interest in regional anesthesia in pediatrics beyond the common caudal, epidural, or spinal. With improvements in equipment that are specific to children and addition of ropivacaine as a proven local anesthetic, pediatric regional anesthesia, and specifically