EEG response to a high volume (1.5 mL/kg) caudal block in infants less than 3 months.

Introduction: The substantial compression of the dural sac and the subsequent cranial shift of cerebrospinal fluid caused by a high-volume caudal block has been shown to significantly but transiently reduce cerebral blood flow. The aim of the present study was to determine whether this reduction in cerebral perfusion is significant enough to alter brain function, as assessed by electroencephalography (EEG).

Methods: Following ethics approval and parental informed consent, 11 infants (0-3 months) scheduled to undergo inguinal hernia repair were included in the study.

Cerebral blood flow alterations associated with high volume caudal block in infants.

Background: High-volume (1.5 ml kg) caudal block in infants results in major reductions of cerebral blood flow velocity (CBFV) and cerebral oxygenation, caused by rostral CSF movement which increases intracranial pressure. The primary aim of this study was to determine the relationship between injected volume and CBFV changes.

Adjunct analgesic drugs to local anaesthetics for neuroaxial blocks in children.

Purpose Of Review: This article reviews various adjunct drugs used in the context of neuroaxial blocks in children and to provide a literature and evidence-based suggestion for the rational use of such adjuncts.

Recent Findings: Contrary to plain local anaesthetics, preservative-free morphine and clonidine, ketamine in neonatal rodents has been found to enhance apoptosis in the spinal cord. Dexmedetomidine has been shown to be equally effective as clonidine as an adjunct to caudal blocks.

Alpha-2 adrenoceptor agonists as adjuncts to peripheral nerve blocks in children: a meta-analysis.

Background: Adult meta-analyses have verified that adjunct use of alpha-2 adrenoceptor agonists (A2AA) together with local anesthetics (LA) will prolong the duration of peripheral nerve blocks. The standard use of A2AAs for peripheral nerve blockade has recently been recommended also in children, but the evidence base in support of this suggestion has to date been equivocal. The purpose of this meta-analysis was to produce evidence-based data regarding the effect in children.

Dexmedetomidine as adjunct to ilioinguinal/iliohypogastric nerve blocks for pediatric inguinal hernia repair: an exploratory randomized controlled trial.

Background: Adult meta-analysis has identified dexmedetomidine as a potentially useful adjunct to prolong the duration of peripheral nerve blocks. However, no data exist regarding the adjuvant use of dexmedetomidine in the setting of pediatric peripheral nerve blocks.

Methods: Using a prospective, randomized, double-blind design, children (1½-8 years, ASA 1-2) scheduled for outpatient inguinal hernia repair were randomized to receive either an ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) with plain ropivacaine 0.

Ultrasound-guided infrapatellar nerve block for anterior cruciate ligament repair: a prospective, randomised, double-blind, placebo-controlled clinical trial.

Background And Objectives: We have previously described an ultrasonography-guided technique to block the infrapatellar nerve that is associated with an extended duration of anaesthesia. The aim of the present study was to investigate the clinical usefulness of this new technique in patients undergoing arthroscopy-assisted anterior cruciate ligament repair.

Methods: Using a prospective, double-blind and placebo-controlled study design, 64 patients were randomised to get an active infrapatellar nerve block (IPNB; 10 ml levobupivacaine 0.

Segmental distribution of high-volume caudal anesthesia in neonates, infants, and toddlers as assessed by ultrasonography.

Background: The aim of this prospective, age-stratified, observational study was to determine the cranial extent of spread of a large volume (1.5 ml·kg(-1) , ropivacaine 0.2%), single-shot caudal epidural injection using real-time ultrasonography.

Ultrasound versus landmark-based technique for ilioinguinal-iliohypogastric nerve blockade in children: the implications on plasma levels of ropivacaine.

Background: Ilioinguinal-iliohypogastric nerve blockade (INB) is associated with high plasma concentrations of local anesthetics (LAs) in children. Ultrasonographic guidance enables exact anatomical administration of LA, which may alter plasma levels. Accordingly, we compared plasma levels of ropivacaine after ultrasonographic versus landmark-based INB.