title: Updates in Pediatric Regional Anesthesia and Its Role in the Treatment of Acute Pain in the Ambulatory Setting.
abstract: OBJECTIVE
  The purpose of this review is to summarize the latest advances in pediatric regional anesthesia with special emphasis on its role in the ambulatory surgical setting.
  
  
  RESULTS
  Undertreated pain in children following ambulatory surgery is not a rare occurrence and it is associated with increased morbidity and significant psychosocial harm. Use of regional anesthesia as part of the anesthetic approach in the ambulatory setting is safe when performed on children under general anesthesia and inclusion of certain adjuncts improves block outcomes. Ultrasonographic visualization during blockade improves safety and prolongs duration. Ambulatory continuous nerve blocks in older children are safe, efficacious, and associated with high patient and caregiver satisfaction rates. In the ever-growing field of pediatric same-day surgery, safe and efficient flow through the perioperative period necessitates use of a multimodal approach, of which regional anesthesia is but one important component. Perioperative complications are minimized with less opioid use, and yet appropriate pain management must be ensured. Pediatric regional anesthesia has been shown to be exceedingly safe under general anesthesia. Findings demonstrate that advances in ultrasound technology have contributed to safer and longer-lasting analgesia. It facilitates the development of new methods by which regional anesthesia can improve postoperative analgesia in children upon discharge and beyond.
authors.affiliation: Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative, and Pain Medicine, Miller School of Medicine, University of Miami, 1611 NW 12th Avenue, C302, Miami, FL, 33136, USA. asabartinelli@med.miami.edu.
authors.forename: Alecia L S
authors.initials: AL
authors.lastname: Stein
authors.affiliation: Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative, and Pain Medicine, Miller School of Medicine, University of Miami, 1611 NW 12th Avenue, C302, Miami, FL, 33136, USA.|Department of Anesthesiology, VA Medical Center, 1201 NW 16th Street, Miami, FL, 33136, USA.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Baumgard
authors.affiliation: Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative, and Pain Medicine, Miller School of Medicine, University of Miami, 1611 NW 12th Avenue, C302, Miami, FL, 33136, USA.
authors.forename: Isis
authors.initials: I
authors.lastname: Del Rio
authors.affiliation: Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative, and Pain Medicine, Miller School of Medicine, University of Miami, 1611 NW 12th Avenue, C302, Miami, FL, 33136, USA.
authors.forename: Jacqueline L
authors.initials: JL
authors.lastname: Tutiven
mesh_terms: D059787:Acute Pain / Q000601:surgery*; D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D059408:Pain Management / Q000379:methods*; D010372:Pediatrics / Q000379:methods
keywords: Pediatric acute pain; Pediatric ambulatory anesthesia; Pediatric analgesia; Pediatric anesthesia; Pediatric regional anesthesia