RT Book, Section
A1 Bosenberg, Adrian T.
A1 Kandiah, Nishanthi
A2 Ellinas, Herodotos
A2 Matthes, Kai
A2 Alrayashi, Walid
A2 Bilge, Aykut
SR Print(0)
ID 1176459316
T1 Regional Anesthesia: Head and Neck Blocks
T2 Clinical Pediatric Anesthesiology
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781259585746
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1176459316
RD 2024/04/20
AB FOCUS  POINTSHand  and  neck  blocks  can  be  used  to  relieve  pain  and  supplement  general  anesthesia  in  infants  and  children  undergoing  head  and  neck  surgery.1,2  Block  selection  depends  on  the  surgical  approach.  Most  anesthesiologists  have  limited  opportunity  to  perform  these  blocks  since  major  surgery  of  the  face  and  neck  is  relatively  uncommon  and  local  infiltration  is  often  used  for  most  minor  procedures.3,4Local  infiltration  provides  a  circumscribed  area  of  anesthesia  in  the  immediate  vicinity  of  injection  and  large  volumes  of  local  anesthetic  may  be  required.  A  nerve  block  on  the  other  hand  provides  a  larger  area  of  anesthesia  for  a  relatively  small  volume  of  local  anesthetic.Most  children  have  an  inherent  fear  of  needles,  particularly  around  the  facial  area.  This  precludes  its  use  in  young  children  (and  in  some  older  children!)  without  sedation  or  general  anesthesia.The  anatomical  landmarks  are  relatively  constant  in  adults  but  structural  changes  that  occur  during  growth  of  a  child  results  in  some  variability.  A  thorough  understanding  of  the  anatomical  relationship  of  the  nerve  to  be  blocked  is  essential  since  the  anatomy  of  the  head  and  neck  is  compact  and  the  cranial  and  cervical  nerves  are  close  to  vital  structures.  Inadvertent  injection  into  these  blood  vessels  carries  a  significant  risk  of  toxicity.