The Role of Regional Anesthesia in Neonatal Care: A Review
Main Article Content
Abstract
Effective pain management in neonates is critical, as inadequate treatment can result in both immediate complications and long-term cognitive and behavioral issues. Neonates, particularly preterm infants, have heightened sensitivity to pain, which necessitates the use of specialized pain management techniques. Regional anesthesia (RA) offers significant benefits in this patient population, including reducing the need for opioids and their associated risks, minimizing the stress response, and improving postoperative outcomes. Despite its proven efficacy in pediatric and adult populations, there is limited published evidence regarding RA's use in neonates. This article reviews the fundamental science, clinical applications, and safety considerations of regional anesthesia in neonates, focusing on four modalities: neuraxial blocks, peripheral nerve blocks, fascial plane blocks, and analgesic catheters. While RA has been shown to provide superior pain control and reduce opioid consumption, safety is paramount, especially considering the unique physiological characteristics of neonates.
Article Details
How to Cite
E., Balverde Camiño; F., Terra Laurent; F., Cristiani Halty.
The Role of Regional Anesthesia in Neonatal Care: A Review.
Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5927>. Date accessed: 15 nov. 2024.
doi: https://doi.org/10.18103/mra.v12i10.5927.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Prevention and management of pain and stress in the neonate. American Academy of Pediatrics. Committee on Fetus and Newborn. Committee on Drugs. Section on Anesthesiology. Section on Surgery. Canadian Paediatric Society. Fetus and Newborn Committee. Pediatrics. 2000;105(2):454-461.
2. Grunau RE, Holsti L, Peters JW. Long-term consequences of pain in human neonates. Semin Fetal Neonatal Med. 2006;11(4):268-275. doi:10.1016/j.siny.2006.02.007
3. Anand KJS, Papanicolaou AC, Palmer FB. Repetitive neonatal pain and neurocognitive abilities in ex-preterm children. Pain. 2013;154(10):1899-1901. doi:10.1016/j.pain.2013.06.027
4. Simons SH, van Dijk M, Anand KS, Roofthooft D, van Lingen RA, Tibboel D. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates. Arch Pediatr Adolesc Med. 2003;157(11):1058-1064. doi:10.1001/archpedi.157.11.1058
5. Selvanathan T, Zaki P, McLean MA, et al. Early-life exposure to analgesia and 18-month neurodevelopmental outcomes in very preterm infants. Pediatr Res. 2023;94(2):738-746. doi:10.1038/s41390-023-02536-y
6. Ferguson SA, Ward WL, Paule MG, Hall RW, Anand KJ. A pilot study of preemptive morphine analgesia in preterm neonates: effects on head circumference, social behavior, and response latencies in early childhood. Neurotoxicol Teratol. 2012;34(1):47-55. doi:10.1016/j.ntt.2011.10.008
7. McPherson C, Miller SP, El-Dib M, Massaro AN, Inder TE. The influence of pain, agitation, and their management on the immature brain. Pediatr Res. 2020;88(2):168-175. doi:10.1038/s41390-019-0744-6
8. Reissland N, Francis B, Mason J. Can healthy fetuses show facial expressions of "pain" or "distress"?. PLoS One. 2013;8(6):e65530. Published 2013 Jun 5. doi:10.1371/journal.pone.0065530
9. Sekulic S, Gebauer-Bukurov K, Cvijanovic M, et al. Appearance of fetal pain could be associated with maturation of the mesodiencephalic structures. J Pain Res. 2016;9:1031-1038. Published 2016 Nov 11. doi:10.2147/JPR.S117959
10. Pattinson D, Fitzgerald M. The neurobiology of infant pain: development of excitatory and inhibitory neurotransmission in the spinal dorsal horn. Reg Anesth Pain Med. 2004;29(1):36-44. doi:10.1016/j.rapm.2003.10.018
11. Lowery CL, Hardman MP, Manning N, Hall RW, Anand KJ, Clancy B. Neurodevelopmental changes of fetal pain [published correction appears in Semin Perinatol. 2009 Dec;33(6):410. Clancy, Barbara [added]]. Semin Perinatol. 2007;31(5):275-282. doi:10.1053/j.semperi.2007.07.004
12. Torsney C, Fitzgerald M. Spinal dorsal horn cell receptive field size is increased in adult rats following neonatal hindpaw skin injury. J Physiol. 2003;550(Pt 1):255-261. doi:10.1113/jphysiol.2003.043661
13. Ririe DG, Bremner LR, Fitzgerald M. Comparison of the immediate effects of surgical incision on dorsal horn neuronal receptive field size and responses during postnatal development. Anesthesiology. 2008;109(4):698-706. doi:10.1097/ALN.0b013e3181870a32
14. Walker SM, Tochiki KK, Fitzgerald M. Hindpaw incision in early life increases the hyperalgesic response to repeat surgical injury: critical period and dependence on initial afferent activity. Pain. 2009;147(1-3):99-106. doi:10.1016/j.pain.2009.08.017
15. Benzon HT, Strichartz GR, Gissen AJ, Shanks CA, Covino BG, Datta S. Developmental neurophysiology of mammalian peripheral nerves and age-related differential sensitivity to local anaesthetic. Br J Anaesth. 1988;61(6):754-760. doi:10.1093/bja/61.6.75417
16. Cristiani F, Henderson R, Lauber C, Boretsky K. Success of bedside ultrasound to identify puncture site for spinal anesthesia in neonates and infants. Reg Anesth Pain Med. Published online July 3, 2019. doi:10.1136/rapm-2019-100672
17. Coté CJ, Lerman J, Anderson BJ. A Practice of Anesthesia for Infants and Children. 6th ed. Elsevier; 2019.. 1192 p.
18. Benzon HT, Strichartz GR, Gissen AJ, Shanks CA, Covino BG, Datta S. Developmental neurophysiology of mammalian peripheral nerves and age-related differential sensitivity to local anaesthetic. Br J Anaesth. 1988;61(6):754-760. doi:10.1093/bja/61.6.754
19. Davidson AJ, Disma N, de Graaff JC, et al. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial [published correction appears in Lancet. 2016 Jan 16;387(10015):228. doi: 10.1016/S0140-6736(16)00054-4]. Lancet. 2016;387(10015):239-250. doi:10.1016/S0140-6736(15)00608-X
20. Mansfield SA, Woodroof J, Murphy AJ, Davidoff AM, Morgan KJ. Does epidural analgesia really enhance recovery in pediatric surgery patients?. Pediatr Surg Int. 2021;37(9):1201-1206. doi:10.1007/s00383-021-04897-z
21. Franz AM, Martin LD, Liston DE, Latham GJ, Richards MJ, Low DK. In Pursuit of an Opioid-Free Pediatric Ambulatory Surgery Center: A Quality Improvement Initiative. Anesth Analg. 2021;132(3):788-797. doi:10.1213/ANE.0000000000004774
22. Davidson AJ, Morton NS, Arnup SJ, et al. Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial. Anesthesiology. 2015;123(1):38-54. doi:10.1097/ALN.0000000000000709
23. Bösenberg AT, Hadley GP, Wiersma R. Oesophageal atresia: caudo-thoracic epidural anaesthesia reduces the need for post-operative ventilatory support. Pediatric Surgery International. 1992;7(4):289-291. doi:https://doi.org/10.1007/bf00183983
24. Ecoffey C, Dubousset AM, Samii K. Lumbar and thoracic epidural anesthesia for urologic and upper abdominal surgery in infants and children. Anesthesiology. 1986;65(1):87-90. doi:10.1097/00000542-198607000-00017
25. Wilson GA, Brown JL, Crabbe DG, Hinton W, McHugh PJ, Stringer MD. Is epidural analgesia associated with an improved outcome following open Nissen fundoplication?. Paediatr Anaesth. 2001;11(1):65-70. doi:10.1046/j.1460-9592.2001.00597.x
26. Wolf AR. Effects of regional analgesia on stress responses to pediatric surgery. Paediatr Anaesth. 2012;22(1):19-24. doi:10.1111/j.1460-9592.2011.03714.x,
27. Snyder GL, Greenberg S. Effect of anaesthetic technique and other perioperative factors on cancer recurrence. Br J Anaesth. 2010;105(2):106-115. doi:10.1093/bja/aeq164
28. Hoehn T, Jetzek-Zader M, Blohm M, Mayatepek E. Early peristalsis following epidural analgesia during abdominal surgery in an extremely low birth weight infant. Paediatr Anaesth. 2007;17(2):176-179. doi:10.1111/j.1460-9592.2006.02038.x
29. Garcia Guerra G, Robertson CM, Alton GY, et al. Neurotoxicity of sedative and analgesia drugs in young infants with congenital heart disease: 4-year follow-up. Paediatr Anaesth. 2014;24(3):257-265. doi:10.1111/pan.12257
30. Davis PJ, Cladis FP. Smith’s Anesthesia for Infants and Children E-Book. Elsevier Health Sciences; 2016:1425.
31. Lerman J, Strong HA, LeDez KM, Swartz J, Rieder MJ, Burrows FA. Effects of age on the serum concentration of alpha 1-acid glycoprotein and the binding of lidocaine in pediatric patients. Clin Pharmacol Ther. 1989;46(2):219-225. doi:10.1038/clpt.1989.129
32. Neal JM, Neal EJ, Weinberg GL. American Society of Regional Anesthesia and Pain Medicine Local Anesthetic Systemic Toxicity checklist: 2020 version. Reg Anesth Pain Med. 2021;46(1):81-82. doi:10.1136/rapm-2020-101986
33. Lönnqvist PA. Toxicity of local anesthetic drugs: a pediatric perspective. Paediatr Anaesth. 2012;22(1):39-43. doi:10.1111/j.1460-9592.2011.03631.x
34. Neal JM, Barrington MJ, Fettiplace MR, et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017. Reg Anesth Pain Med. 2018;43(2):113-123. doi:10.1097/AAP.0000000000000720
35. Boretsky K, Visoiu M, Bigeleisen P. Ultrasound-guided approach to the paravertebral space for catheter insertion in infants and children. Paediatr Anaesth. 2013;23(12):1193-1198. doi:10.1111/pan.12238
36. Adlan S, Abd El-Rahman A, Mohamed SA, et al. Systemic Analgesia versus Continuous Erector Spinae Plane Block (ESPB) Infusion During Paediatric Nephrectomy: A Randomized, Controlled Trial. Local Reg Anesth. 2023;16:59-69. Published 2023 Jun 5. doi:10.2147/LRA.S401980
37. Tognù A, Cauli V, de Simone N, Aurini L, Manfrini M, Bonarelli S. In-Plane Ultrasound-Guided Lumbar Plexus Block Using Catheter-Over-Needle Technique in a 14-Month-Old Baby. Reg Anesth Pain Med. 2016;41(4):538-541. doi:10.1097/AAP.0000000000000417
38. Kaplan I, Jiao Y, AuBuchon JD, Moore RP. Continuous Erector Spinae Plane Catheter for Analgesia After Infant Thoracotomy: A Case Report. A A Pract. 2018;11(9):250-252. doi:10.1213/XAA.0000000000000799
39. Kaushal B, Chauhan S, Saini K, et al. Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block, Pectoral Nerves II Block, and Intercostal Nerve Block for the Management of Postoperative Thoracotomy Pain After Pediatric Cardiac Surgery. J Cardiothorac Vasc Anesth. 2019;33(2):418-425. doi:10.1053/j.jvca.2018.08.209
40. Kelleher S, Boretsky K, Alrayashi W. Images in Anesthesiology: Use of Ultrasound to Facilitate Neonatal Spinal Anesthesia. Anesthesiology. 2017;126(3):561. doi:10.1097/ALN.0000000000001468
41. Cristiani F, Henderson R, Lauber C, Boretsky K. Success of bedside ultrasound to identify puncture site for spinal anesthesia in neonates and infants. Regional Anesthesia & Pain Medicine. 2019;44(9):893-895. doi:https://doi.org/10.1136/rapm-2019-100672
42. Oberndorfer U, Marhofer P, Bösenberg A, et al. Ultrasonographic guidance for sciatic and femoral nerve blocks in children. Br J Anaesth. 2007;98(6):797-801. doi:10.1093/bja/aem092
43. Lam DK, Corry GN, Tsui BC. Evidence for the Use of Ultrasound Imaging in Pediatric Regional Anesthesia: A Systematic Review. Reg Anesth Pain Med. 2016;41(2):229-241. doi:10.1097/AAP.0000000000000208
44. Scott NB, Turfrey DJ, Ray DA, et al. A prospective randomized study of the potential benefits of thoracic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. Anesth Analg. 2001;93(3):528-535. doi:10.1097/00000539-200109000-00003
45. Liu SS, Block BM, Wu CL. Effects of perioperative central neuraxial analgesia on outcome after coronary artery bypass surgery: a meta-analysis. Anesthesiology. 2004;101(1):153-161. doi:10.1097/00000542-200407000-00024
46. Mohamed SK, Ibraheem AS, Abdelraheem MG. Preoperative intravenous dexamethasone combined with glossopharyngeal nerve block: role in pediatric postoperative analgesia following tonsillectomy. Eur Arch Otorhinolaryngol. 2009;266(11):1815-1819. doi:10.1007/s00405-009-0937-4
47. Carney J, Finnerty O, Rauf J, Curley G, McDonnell JG, Laffey JG. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial. Anesth Analg. 2010;111(4):998-1003. doi:10.1213/ANE.0b013e3181ee7bba
48. Chaudhary V, Chauhan S, Choudhury M, Kiran U, Vasdev S, Talwar S. Parasternal intercostal block with ropivacaine for postoperative analgesia in pediatric patients undergoing cardiac surgery: a double-blind, randomized, controlled study. J Cardiothorac Vasc Anesth. 2012;26(3):439-442. doi:10.1053/j.jvca.2011.10.012
49. Brindle ME, McDiarmid C, Short K, et al. Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World J Surg. 2020;44(8):2482-2492. doi:10.1007/s00268-020-05530-1
50. Richtrová M, Košková O, Janků M, Bönischová T, Fabián D, Štourač P. Regional anesthesia in neonates with cleft lip and palate: Retrospective study. Int J Pediatr Otorhinolaryngol. 2024;180:111965. doi:10.1016/j.ijporl.2024.111965
51. Somri M, Matter I, Parisinos CA, et al. The effect of combined spinal-epidural anesthesia versus general anesthesia on the recovery time of intestinal function in young infants undergoing intestinal surgery: a randomized, prospective, controlled trial. J Clin Anesth. 2012;24(6):439-445. doi:10.1016/j.jclinane.2012.02.004
52. Hoffmann C, Snow A, Chedid C, Abi Shadid C, Miyasaka EA. Quadratus Lumborum Block as a Cornerstone for Neonatal Intestinal Surgery Enhanced Recovery (ERAS): A Case Series. Local Reg Anesth. 2023;16:165-171. Published 2023 Oct 10. doi:10.2147/LRA.S403567
53. Walker BJ, Long JB, Sathyamoorthy M, et al. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network. Anesthesiology. 2018;129(4):721-732. doi:10.1097/ALN.0000000000002372
54. Ecoffey C, Lacroix F, Giaufré E, Orliaguet G, Courrèges P; Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF). Epidemiology and morbidity of regional anesthesia in children: a follow-up one-year prospective survey of the French-Language Society of Paediatric Anaesthesiologists (ADARPEF). Paediatr Anaesth. 2010;20(12):1061-1069. doi:10.1111/j.1460-9592.2010.03448.x
55. Walker BJ, Long JB, Sathyamoorthy M, et al. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network. Anesthesiology. 2018;129(4):721-732. doi:10.1097/ALN.0000000000002372
56. Brown TC. History of pediatric regional anesthesia. Paediatr Anaesth. 2012;22(1):3-9. doi:10.1111/j.1460-9592.2011.03636.x
57. Davidson AJ, Morton NS, Arnup SJ, et al. Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial. Anesthesiology. 2015;123(1):38-54. doi:10.1097/ALN.0000000000000709
58. Somri M, Gaitini L, Vaida S, Collins G, Sabo E, Mogilner G. Postoperative outcome in high-risk infants undergoing herniorrhaphy: comparison between spinal and general anaesthesia. Anaesthesia. 1998;53(8):762-766. doi:10.1046/j.1365-2044.1998.00431.x
59. Welborn LG, Rice LJ, Hannallah RS, Broadman LM, Ruttimann UE, Fink R. Postoperative apnea in former preterm infants: prospective comparison of spinal and general anesthesia. Anesthesiology. 1990;72(5):838-842. doi:10.1097/00000542-199005000-00012
60. McCann ME, de Graaff JC, Dorris L, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial [published correction appears in Lancet. 2019 Aug 24;394(10199):638. doi: 10.1016/S0140-6736(19)31958-0]. Lancet. 2019;393(10172):664-677. doi:10.1016/S0140-6736(18)32485-1
61. Lauber C, Sánchez A, Cerizola M, Pereira S, González AMR. Implementación de un protocolo de anestesia raquídea para reparación de hernia inguinal en lactantes nacidos prematuros: Experiencia en el Centro Hospitalario Pereira Rossell. Published September 30, 2014. https://revista.rmu.org.uy/index.php/rmu/article/view/238
62. Wiegele M, Marhofer P, Lönnqvist PA. Caudal epidural blocks in paediatric patients: a review and practical considerations. Br J Anaesth. 2019;122(4):509-517. doi:10.1016/j.bja.2018.11.030
63. Suresh S, Ecoffey C, Bosenberg A, et al. The European Society of Regional Anaesthesia and Pain Therapy/American Society of Regional Anesthesia and Pain Medicine Recommendations on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia. Reg Anesth Pain Med. 2018;43(2):211-216. doi:10.1097/AAP.0000000000000702
64. Polaner DM, Taenzer AH, Walker BJ, et al. Pediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia. Anesth Analg. 2012;115(6):1353-1364. doi:10.1213/ANE.0b013e31825d9f4b
65. Taenzer AH, Walker BJ, Bosenberg AT, et al. Asleep versus awake: does it matter?: Pediatric regional block complications by patient state: a report from the Pediatric Regional Anesthesia Network. Reg Anesth Pain Med. 2014;39(4):279-283. doi:10.1097/AAP.0000000000000102
66. Ivani G, Suresh S, Ecoffey C, et al. The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia. Reg Anesth Pain Med. 2015;40(5):526-532. doi:10.1097/AAP.0000000000000280
67. Suresh S, Lonnqvist PA. Regional anesthesia in children. In: Gropper MA, ed. Millers Anesthesia. 9th ed. Philadelphia: Elsevier; 2020:2368-2419.
68. Elsharkawy H, Pawa A, Mariano ER. Interfascial Plane Blocks: Back to Basics. Reg Anesth Pain Med. 2018;43(4):341-346. doi:10.1097/AAP.0000000000000750
2. Grunau RE, Holsti L, Peters JW. Long-term consequences of pain in human neonates. Semin Fetal Neonatal Med. 2006;11(4):268-275. doi:10.1016/j.siny.2006.02.007
3. Anand KJS, Papanicolaou AC, Palmer FB. Repetitive neonatal pain and neurocognitive abilities in ex-preterm children. Pain. 2013;154(10):1899-1901. doi:10.1016/j.pain.2013.06.027
4. Simons SH, van Dijk M, Anand KS, Roofthooft D, van Lingen RA, Tibboel D. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates. Arch Pediatr Adolesc Med. 2003;157(11):1058-1064. doi:10.1001/archpedi.157.11.1058
5. Selvanathan T, Zaki P, McLean MA, et al. Early-life exposure to analgesia and 18-month neurodevelopmental outcomes in very preterm infants. Pediatr Res. 2023;94(2):738-746. doi:10.1038/s41390-023-02536-y
6. Ferguson SA, Ward WL, Paule MG, Hall RW, Anand KJ. A pilot study of preemptive morphine analgesia in preterm neonates: effects on head circumference, social behavior, and response latencies in early childhood. Neurotoxicol Teratol. 2012;34(1):47-55. doi:10.1016/j.ntt.2011.10.008
7. McPherson C, Miller SP, El-Dib M, Massaro AN, Inder TE. The influence of pain, agitation, and their management on the immature brain. Pediatr Res. 2020;88(2):168-175. doi:10.1038/s41390-019-0744-6
8. Reissland N, Francis B, Mason J. Can healthy fetuses show facial expressions of "pain" or "distress"?. PLoS One. 2013;8(6):e65530. Published 2013 Jun 5. doi:10.1371/journal.pone.0065530
9. Sekulic S, Gebauer-Bukurov K, Cvijanovic M, et al. Appearance of fetal pain could be associated with maturation of the mesodiencephalic structures. J Pain Res. 2016;9:1031-1038. Published 2016 Nov 11. doi:10.2147/JPR.S117959
10. Pattinson D, Fitzgerald M. The neurobiology of infant pain: development of excitatory and inhibitory neurotransmission in the spinal dorsal horn. Reg Anesth Pain Med. 2004;29(1):36-44. doi:10.1016/j.rapm.2003.10.018
11. Lowery CL, Hardman MP, Manning N, Hall RW, Anand KJ, Clancy B. Neurodevelopmental changes of fetal pain [published correction appears in Semin Perinatol. 2009 Dec;33(6):410. Clancy, Barbara [added]]. Semin Perinatol. 2007;31(5):275-282. doi:10.1053/j.semperi.2007.07.004
12. Torsney C, Fitzgerald M. Spinal dorsal horn cell receptive field size is increased in adult rats following neonatal hindpaw skin injury. J Physiol. 2003;550(Pt 1):255-261. doi:10.1113/jphysiol.2003.043661
13. Ririe DG, Bremner LR, Fitzgerald M. Comparison of the immediate effects of surgical incision on dorsal horn neuronal receptive field size and responses during postnatal development. Anesthesiology. 2008;109(4):698-706. doi:10.1097/ALN.0b013e3181870a32
14. Walker SM, Tochiki KK, Fitzgerald M. Hindpaw incision in early life increases the hyperalgesic response to repeat surgical injury: critical period and dependence on initial afferent activity. Pain. 2009;147(1-3):99-106. doi:10.1016/j.pain.2009.08.017
15. Benzon HT, Strichartz GR, Gissen AJ, Shanks CA, Covino BG, Datta S. Developmental neurophysiology of mammalian peripheral nerves and age-related differential sensitivity to local anaesthetic. Br J Anaesth. 1988;61(6):754-760. doi:10.1093/bja/61.6.75417
16. Cristiani F, Henderson R, Lauber C, Boretsky K. Success of bedside ultrasound to identify puncture site for spinal anesthesia in neonates and infants. Reg Anesth Pain Med. Published online July 3, 2019. doi:10.1136/rapm-2019-100672
17. Coté CJ, Lerman J, Anderson BJ. A Practice of Anesthesia for Infants and Children. 6th ed. Elsevier; 2019.. 1192 p.
18. Benzon HT, Strichartz GR, Gissen AJ, Shanks CA, Covino BG, Datta S. Developmental neurophysiology of mammalian peripheral nerves and age-related differential sensitivity to local anaesthetic. Br J Anaesth. 1988;61(6):754-760. doi:10.1093/bja/61.6.754
19. Davidson AJ, Disma N, de Graaff JC, et al. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial [published correction appears in Lancet. 2016 Jan 16;387(10015):228. doi: 10.1016/S0140-6736(16)00054-4]. Lancet. 2016;387(10015):239-250. doi:10.1016/S0140-6736(15)00608-X
20. Mansfield SA, Woodroof J, Murphy AJ, Davidoff AM, Morgan KJ. Does epidural analgesia really enhance recovery in pediatric surgery patients?. Pediatr Surg Int. 2021;37(9):1201-1206. doi:10.1007/s00383-021-04897-z
21. Franz AM, Martin LD, Liston DE, Latham GJ, Richards MJ, Low DK. In Pursuit of an Opioid-Free Pediatric Ambulatory Surgery Center: A Quality Improvement Initiative. Anesth Analg. 2021;132(3):788-797. doi:10.1213/ANE.0000000000004774
22. Davidson AJ, Morton NS, Arnup SJ, et al. Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial. Anesthesiology. 2015;123(1):38-54. doi:10.1097/ALN.0000000000000709
23. Bösenberg AT, Hadley GP, Wiersma R. Oesophageal atresia: caudo-thoracic epidural anaesthesia reduces the need for post-operative ventilatory support. Pediatric Surgery International. 1992;7(4):289-291. doi:https://doi.org/10.1007/bf00183983
24. Ecoffey C, Dubousset AM, Samii K. Lumbar and thoracic epidural anesthesia for urologic and upper abdominal surgery in infants and children. Anesthesiology. 1986;65(1):87-90. doi:10.1097/00000542-198607000-00017
25. Wilson GA, Brown JL, Crabbe DG, Hinton W, McHugh PJ, Stringer MD. Is epidural analgesia associated with an improved outcome following open Nissen fundoplication?. Paediatr Anaesth. 2001;11(1):65-70. doi:10.1046/j.1460-9592.2001.00597.x
26. Wolf AR. Effects of regional analgesia on stress responses to pediatric surgery. Paediatr Anaesth. 2012;22(1):19-24. doi:10.1111/j.1460-9592.2011.03714.x,
27. Snyder GL, Greenberg S. Effect of anaesthetic technique and other perioperative factors on cancer recurrence. Br J Anaesth. 2010;105(2):106-115. doi:10.1093/bja/aeq164
28. Hoehn T, Jetzek-Zader M, Blohm M, Mayatepek E. Early peristalsis following epidural analgesia during abdominal surgery in an extremely low birth weight infant. Paediatr Anaesth. 2007;17(2):176-179. doi:10.1111/j.1460-9592.2006.02038.x
29. Garcia Guerra G, Robertson CM, Alton GY, et al. Neurotoxicity of sedative and analgesia drugs in young infants with congenital heart disease: 4-year follow-up. Paediatr Anaesth. 2014;24(3):257-265. doi:10.1111/pan.12257
30. Davis PJ, Cladis FP. Smith’s Anesthesia for Infants and Children E-Book. Elsevier Health Sciences; 2016:1425.
31. Lerman J, Strong HA, LeDez KM, Swartz J, Rieder MJ, Burrows FA. Effects of age on the serum concentration of alpha 1-acid glycoprotein and the binding of lidocaine in pediatric patients. Clin Pharmacol Ther. 1989;46(2):219-225. doi:10.1038/clpt.1989.129
32. Neal JM, Neal EJ, Weinberg GL. American Society of Regional Anesthesia and Pain Medicine Local Anesthetic Systemic Toxicity checklist: 2020 version. Reg Anesth Pain Med. 2021;46(1):81-82. doi:10.1136/rapm-2020-101986
33. Lönnqvist PA. Toxicity of local anesthetic drugs: a pediatric perspective. Paediatr Anaesth. 2012;22(1):39-43. doi:10.1111/j.1460-9592.2011.03631.x
34. Neal JM, Barrington MJ, Fettiplace MR, et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017. Reg Anesth Pain Med. 2018;43(2):113-123. doi:10.1097/AAP.0000000000000720
35. Boretsky K, Visoiu M, Bigeleisen P. Ultrasound-guided approach to the paravertebral space for catheter insertion in infants and children. Paediatr Anaesth. 2013;23(12):1193-1198. doi:10.1111/pan.12238
36. Adlan S, Abd El-Rahman A, Mohamed SA, et al. Systemic Analgesia versus Continuous Erector Spinae Plane Block (ESPB) Infusion During Paediatric Nephrectomy: A Randomized, Controlled Trial. Local Reg Anesth. 2023;16:59-69. Published 2023 Jun 5. doi:10.2147/LRA.S401980
37. Tognù A, Cauli V, de Simone N, Aurini L, Manfrini M, Bonarelli S. In-Plane Ultrasound-Guided Lumbar Plexus Block Using Catheter-Over-Needle Technique in a 14-Month-Old Baby. Reg Anesth Pain Med. 2016;41(4):538-541. doi:10.1097/AAP.0000000000000417
38. Kaplan I, Jiao Y, AuBuchon JD, Moore RP. Continuous Erector Spinae Plane Catheter for Analgesia After Infant Thoracotomy: A Case Report. A A Pract. 2018;11(9):250-252. doi:10.1213/XAA.0000000000000799
39. Kaushal B, Chauhan S, Saini K, et al. Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block, Pectoral Nerves II Block, and Intercostal Nerve Block for the Management of Postoperative Thoracotomy Pain After Pediatric Cardiac Surgery. J Cardiothorac Vasc Anesth. 2019;33(2):418-425. doi:10.1053/j.jvca.2018.08.209
40. Kelleher S, Boretsky K, Alrayashi W. Images in Anesthesiology: Use of Ultrasound to Facilitate Neonatal Spinal Anesthesia. Anesthesiology. 2017;126(3):561. doi:10.1097/ALN.0000000000001468
41. Cristiani F, Henderson R, Lauber C, Boretsky K. Success of bedside ultrasound to identify puncture site for spinal anesthesia in neonates and infants. Regional Anesthesia & Pain Medicine. 2019;44(9):893-895. doi:https://doi.org/10.1136/rapm-2019-100672
42. Oberndorfer U, Marhofer P, Bösenberg A, et al. Ultrasonographic guidance for sciatic and femoral nerve blocks in children. Br J Anaesth. 2007;98(6):797-801. doi:10.1093/bja/aem092
43. Lam DK, Corry GN, Tsui BC. Evidence for the Use of Ultrasound Imaging in Pediatric Regional Anesthesia: A Systematic Review. Reg Anesth Pain Med. 2016;41(2):229-241. doi:10.1097/AAP.0000000000000208
44. Scott NB, Turfrey DJ, Ray DA, et al. A prospective randomized study of the potential benefits of thoracic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. Anesth Analg. 2001;93(3):528-535. doi:10.1097/00000539-200109000-00003
45. Liu SS, Block BM, Wu CL. Effects of perioperative central neuraxial analgesia on outcome after coronary artery bypass surgery: a meta-analysis. Anesthesiology. 2004;101(1):153-161. doi:10.1097/00000542-200407000-00024
46. Mohamed SK, Ibraheem AS, Abdelraheem MG. Preoperative intravenous dexamethasone combined with glossopharyngeal nerve block: role in pediatric postoperative analgesia following tonsillectomy. Eur Arch Otorhinolaryngol. 2009;266(11):1815-1819. doi:10.1007/s00405-009-0937-4
47. Carney J, Finnerty O, Rauf J, Curley G, McDonnell JG, Laffey JG. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial. Anesth Analg. 2010;111(4):998-1003. doi:10.1213/ANE.0b013e3181ee7bba
48. Chaudhary V, Chauhan S, Choudhury M, Kiran U, Vasdev S, Talwar S. Parasternal intercostal block with ropivacaine for postoperative analgesia in pediatric patients undergoing cardiac surgery: a double-blind, randomized, controlled study. J Cardiothorac Vasc Anesth. 2012;26(3):439-442. doi:10.1053/j.jvca.2011.10.012
49. Brindle ME, McDiarmid C, Short K, et al. Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World J Surg. 2020;44(8):2482-2492. doi:10.1007/s00268-020-05530-1
50. Richtrová M, Košková O, Janků M, Bönischová T, Fabián D, Štourač P. Regional anesthesia in neonates with cleft lip and palate: Retrospective study. Int J Pediatr Otorhinolaryngol. 2024;180:111965. doi:10.1016/j.ijporl.2024.111965
51. Somri M, Matter I, Parisinos CA, et al. The effect of combined spinal-epidural anesthesia versus general anesthesia on the recovery time of intestinal function in young infants undergoing intestinal surgery: a randomized, prospective, controlled trial. J Clin Anesth. 2012;24(6):439-445. doi:10.1016/j.jclinane.2012.02.004
52. Hoffmann C, Snow A, Chedid C, Abi Shadid C, Miyasaka EA. Quadratus Lumborum Block as a Cornerstone for Neonatal Intestinal Surgery Enhanced Recovery (ERAS): A Case Series. Local Reg Anesth. 2023;16:165-171. Published 2023 Oct 10. doi:10.2147/LRA.S403567
53. Walker BJ, Long JB, Sathyamoorthy M, et al. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network. Anesthesiology. 2018;129(4):721-732. doi:10.1097/ALN.0000000000002372
54. Ecoffey C, Lacroix F, Giaufré E, Orliaguet G, Courrèges P; Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF). Epidemiology and morbidity of regional anesthesia in children: a follow-up one-year prospective survey of the French-Language Society of Paediatric Anaesthesiologists (ADARPEF). Paediatr Anaesth. 2010;20(12):1061-1069. doi:10.1111/j.1460-9592.2010.03448.x
55. Walker BJ, Long JB, Sathyamoorthy M, et al. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network. Anesthesiology. 2018;129(4):721-732. doi:10.1097/ALN.0000000000002372
56. Brown TC. History of pediatric regional anesthesia. Paediatr Anaesth. 2012;22(1):3-9. doi:10.1111/j.1460-9592.2011.03636.x
57. Davidson AJ, Morton NS, Arnup SJ, et al. Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial. Anesthesiology. 2015;123(1):38-54. doi:10.1097/ALN.0000000000000709
58. Somri M, Gaitini L, Vaida S, Collins G, Sabo E, Mogilner G. Postoperative outcome in high-risk infants undergoing herniorrhaphy: comparison between spinal and general anaesthesia. Anaesthesia. 1998;53(8):762-766. doi:10.1046/j.1365-2044.1998.00431.x
59. Welborn LG, Rice LJ, Hannallah RS, Broadman LM, Ruttimann UE, Fink R. Postoperative apnea in former preterm infants: prospective comparison of spinal and general anesthesia. Anesthesiology. 1990;72(5):838-842. doi:10.1097/00000542-199005000-00012
60. McCann ME, de Graaff JC, Dorris L, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial [published correction appears in Lancet. 2019 Aug 24;394(10199):638. doi: 10.1016/S0140-6736(19)31958-0]. Lancet. 2019;393(10172):664-677. doi:10.1016/S0140-6736(18)32485-1
61. Lauber C, Sánchez A, Cerizola M, Pereira S, González AMR. Implementación de un protocolo de anestesia raquídea para reparación de hernia inguinal en lactantes nacidos prematuros: Experiencia en el Centro Hospitalario Pereira Rossell. Published September 30, 2014. https://revista.rmu.org.uy/index.php/rmu/article/view/238
62. Wiegele M, Marhofer P, Lönnqvist PA. Caudal epidural blocks in paediatric patients: a review and practical considerations. Br J Anaesth. 2019;122(4):509-517. doi:10.1016/j.bja.2018.11.030
63. Suresh S, Ecoffey C, Bosenberg A, et al. The European Society of Regional Anaesthesia and Pain Therapy/American Society of Regional Anesthesia and Pain Medicine Recommendations on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia. Reg Anesth Pain Med. 2018;43(2):211-216. doi:10.1097/AAP.0000000000000702
64. Polaner DM, Taenzer AH, Walker BJ, et al. Pediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia. Anesth Analg. 2012;115(6):1353-1364. doi:10.1213/ANE.0b013e31825d9f4b
65. Taenzer AH, Walker BJ, Bosenberg AT, et al. Asleep versus awake: does it matter?: Pediatric regional block complications by patient state: a report from the Pediatric Regional Anesthesia Network. Reg Anesth Pain Med. 2014;39(4):279-283. doi:10.1097/AAP.0000000000000102
66. Ivani G, Suresh S, Ecoffey C, et al. The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia. Reg Anesth Pain Med. 2015;40(5):526-532. doi:10.1097/AAP.0000000000000280
67. Suresh S, Lonnqvist PA. Regional anesthesia in children. In: Gropper MA, ed. Millers Anesthesia. 9th ed. Philadelphia: Elsevier; 2020:2368-2419.
68. Elsharkawy H, Pawa A, Mariano ER. Interfascial Plane Blocks: Back to Basics. Reg Anesth Pain Med. 2018;43(4):341-346. doi:10.1097/AAP.0000000000000750