[Arguments against conduction anesthesia in children].
Regional anaesthesia has been increasingly popular in paediatric patients of all ages, especially because some techniques afford excellent per and post-operative pain relief. However, side effects may occur. Particularly, systemic toxicity from bupivacaine administration is associated with intravascular injection or overdosage. Then, we focused anaesthesiologist's attention on some inconvenients related with these practices. Regional blockade is most of the time performed in conjunction with general anaesthesia. Consequently, these procedures need additional time, material and nurses. There are relatively few absolute indications for regional anaesthesia in children. The decision for using these techniques is influenced by several factors as incidence of complications, local technical expertise. Alternative methods to provide per and post-operative analgesia being available, advantages and side effects of loco-regional anaesthesia have to be opposited. Management of the best method of block, doses and local anaesthetics or adjuvants according age, requires likely specific teaching in training team. An effort to provide appropriate guidelines and training to ward nurses is necessary to improve security when regional blockade is used for postoperative analgesia. In every cases, physician's experience is the best argument of choice.
Lejus
C
C
Département d'Anesthésie-Réanimation Chirurgicale, Hôtel-Dieu, Nantes.
Saunier
H
H
D000367:Age Factors; D000701:Analgesics, Opioid / Q000009:adverse effects; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000191:economics; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D006801:Humans
D000701:Analgesics, Opioid; D000779:Anesthetics, Local
Controverses en ALR chez l'enfant: contre.