TY  - CHAP
M1  - Book, Section
TI  - Regional Anesthesia: Neuraxial
A1  - LaMonica, Donna
A1  - Antoine, Ingrid Fitz-James
A1  - Carullo, Veronica
A2  - Ellinas, Herodotos
A2  - Matthes, Kai
A2  - Alrayashi, Walid
A2  - Bilge, Aykut
PY  - 2021
T2  - Clinical Pediatric Anesthesiology
AB  - FOCUS  POINTSLocal  anesthetics  are  the  primary  medication  utilized  in  regional  and  neuraxial  anesthesia  or  analgesia,  with  or  without  other  adjuvants.The  local  anesthetics  most  commonly  utilized  are  the  amino-amides,  bupivacaine,  and  lidocaine.  However,  given  the  decreased  metabolism  and  clearance  of  amino-amides  and  resultant  increased  risk  of  local  anesthetic  toxicity  in  infants  less  than  6  months,  chloroprocaine  is  preferred  particularly  for  infusions  administered  for  greater  than  48  hours.Adjuvant  analgesics  are  used  in  combination  with  local  anesthetics  to  improve  the  quality  of  neuraxial  analgesia  and  at  the  same  time  decrease  the  concentration  of  local  anesthetic  agent  needed  to  achieve  adequate  analgesia.The  single-shot  caudal  technique  is  the  most  commonly  utilized  neuraxial  technique  for  ambulatory  surgeries  involving  the  truncal  or  lower  extremity  dermatomes.Spinal  anesthesia  can  be  particularly  useful  when  used  as  the  sole  anesthestic  in  ex-premature  and  term  infants  in  an  attempt  to  avoid  intubation  and/or  exposure  to  general  anesthesia.Continuous  epidural  anesthesia/analgesia  is  primarily  utilized  for  surgeries  involving  bilateral  lower  extremities,  open  thoracic  surgeries,  major  intra-abdominal  surgeries  with  visceral  dissection,  or  spinal  surgeries.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/20
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1176459616
ER  -