Introduction of continuous regional techniques for postoperative paediatrics patients: one years' experience from two hospitals.
OBJECTIVE
To review the use, safety and efficacy of continuous regional techniques in children and neonates.


METHODS
The records of all children who received postoperative continuous regional analgesic techniques during the year 1992 at the Starship Children's Hospital and Waikato Base Hospital were reviewed. In both post operative care units orders, procedures and protocols were standardised.


RESULTS
A total of 80 children received these techniques. Patients were cared for in high dependency nursing areas. The two techniques used were epidural and interpleural analgesia. Epidural: The majority (68) had epidural catheters and of these 13 infants were in their first month of life. Major problems occurred in six (9%) of children receiving epidurals--two blocks failed completely, two suffered subarachnoid puncture, one had respiratory depression and one developed a foot-drop. The blockade failure and subarachnoid punctures occurred early in the establishment of paediatric epidural analgesic services. Minor problems included the necessity for morphine supplementation in three (4%) children, leaks about the catheter in seven (10%), nausea and vomiting in six (9%), two (3%) developed pruritus and one block was ceased because of concerns expressed about masking symptoms of compartmental compression. Interpleural: twelve patients were treated with this technique. One neonate suffered a convulsion.


CONCLUSIONS
Major continuous regional techniques in paediatric patients are effective, but because of potential complications, there is a requirement that these blocks be performed, monitored and cared for by staff experienced and trained with these procedures.
Holland
R
R
Paediatric Intensive Care, Children's Health South Pacific, Auckland.
Anderson
B
B
Watson
T
T
McCall
E
E
D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000706:statistics & numerical data; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000706:statistics & numerical data; D002648:Child; D006772:Hospitals, Military; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009520:New Zealand; D011182:Postoperative Care