title: Pediatric nerve blocks: an evidence-based approach.
abstract: Successful injury management is often dependent upon optimal pain control. Many injuries do not require procedural sedation or systemic analgesia, and emergency clinicians have used peripheral nerve blocks for several decades for these injuries. Nerve blocks deliver anesthetic to the nerve that corresponds to the sensory innervation of the area where the wound or injury is located. In the pediatric setting, some nerve block modalities require modification to the approach and techniques commonly used in adult patients due to the age and weight of the child, the ability of the patient to cooperate, and the ability of the emergency clinician to observe pain response. Peripheral nerve blocks have a high rate of success for effective local anesthesia and a low rate of complications, making them an attractive option for analgesia in the management of some injuries. This evidence-based review summarizes the advantages and disadvantages of peripheral nerve blocks, reviews commonly used local anesthetics, describes the landmark technique for the most common nerve blocks used in pediatric emergency medicine, and presents literature on ultrasound-guided technology.
authors.affiliation: Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Sacha
authors.initials: S
authors.lastname: Duchicela
authors.forename: Anthoney
authors.initials: A
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000779:Anesthetics, Local / Q000627:therapeutic use*; D054796:Drug Dosage Calculations; D055416:Evidence-Based Emergency Medicine; D006801:Humans; D009407:Nerve Block / Q000145:classification / Q000379:methods; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D059408:Pain Management / Q000379:methods; D010525:Peripheral Nerves / Q000187:drug effects* / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014947:Wounds and Injuries / Q000145:classification / Q000150:complications*
chemical_list: D000779:Anesthetics, Local