title: Safety of pediatric continuous interscalene block catheters placed under general anesthesia: a single center's experience.
abstract: BACKGROUND
  The use of interscalene catheters is an effective treatment strategy for children and adolescents undergoing shoulder surgery. Although placement of interscalene catheters in the awake child is challenging, some have cautioned against performing regional anesthesia in the patient under general anesthesia. We present a case series of 154 interscalene catheters placed in pediatric patients under general anesthesia and managed in the outpatient setting.
  
  
  METHODS
  A total of 154 interscalene catheters were placed at a single institution between April 2006 and December 2011 using a modified lateral approach. All catheters were placed with the patient under general anesthesia. The patients discharged home with the catheters were followed-up with daily phone calls until removal of the catheter.
  
  
  RESULTS
  Of the 154 patients with an interscalene CPNB, 132 (85.7%) were discharged home with the interscalene CPNB in place. The success rate for the catheters was 92.1% (CI: 86.9-95.7%). The most common reason for catheter failure (6%) was early dislodgement (within 24 h). In addition to these 12 patients, 3 other patients had adverse events related to the interscalene CPNB.
  
  
  CONCLUSIONS
  Interscalene catheter placement under general anesthesia and management on an outpatient basis is feasible in the pediatric population and is associated with a low rate of catheter-related complications.
authors: Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors: H
authors: H
authors: Gurnaney
authors: W T
authors: WT
authors: Muhly
authors: F W
authors: FW
authors: Kraemer
authors: G
authors: G
authors: Cucchiaro
authors: A
authors: A
authors: Ganesh
mesh_terms: D000293:Adolescent; D000577:Amides / Q000008:administration & dosage; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage; D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000295:instrumentation*; D010149:Postoperative Pain / Q000188:drug therapy*; D061214:Patient Safety / Q000706:statistics & numerical data*; D000077212:Ropivacaine; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine