Adverse Events and Complications in Different Types of Regional Anterior Abdominal Wall Blocks in Children

A.A. Albokrinov

Abstract


Regional anesthesia is the important method of anesthetic management in children, but different techniques may have different safety profile. Objective: to study the incidence and nature of adverse events and complications in different types of regional anterior abdominal wall blocks in children. Materials and methods. The study included 156 patients who underwent open surgeries on anterior abdominal wall under propofol-based anesthesia in combination with one of the regional techniques (caudal anesthesia (n = 28), thoracolumbar paravertebral block (n = 49), transversus abdominis plane block (n = 49), iliohypogastric and ilioinguinal nerve block (n = 39) with 0.25% bupivacaine). Incidence and nature of adverse events and complications of regional blocks were studied. Results. We have detected such adverse events and complications, as blood aspiration, cerebrospinal fluid aspiration, need to redo block, more than one attempt to do block, respiratory depression, nausea/vomiting, urinary retention, prolonged motor block. The incidence of complications was highest in the group of caudal anesthesia. Conclusions. Peripheral regional anterior abdominal wall blocks in children have better safety profile and are associated with lower incidence of complications compared to caudal anesthesia.


Keywords


children; anterior abdominal wall; regional anesthesia; caudal block; paravertebral block; transversus abdominis plane block; iliohypogastric and ilioinguinal nerve block; adverse events; complications

References


Альбокрінов А.А. Аналгетична ефективність різних видів блокад передньої черевної стінки у дітей / А.А. Альбокрінов // Хірургія України. — 2015. — № 2(54). — С. 24-28.

Основы доказательной медицины. Учебное пособие для системы послевузовского и дополнительного профессионального образования врачей / Под общей редакцией академика РАМН, профессора Р.Г. Оганова. — М.: Силицея-Полиграф, 2010. — 136 с.

Boretsky K.R. Regional anesthesia in pediatrics: marching forward // Curr. Opin. Anaesthesiol. — 2014 Oct. — 27(5). — 556-60. doi:10.1097/ACO.0000000000000106.

Carsi B., Gould A., Clarke N.M. Bladder control increases the incidence of urinary retention after epidural analgesia after paediatric orthopaedic surgery // Br. J. Anaesth. — 2012 Aug. — 109(2). — 294-5. doi:10.1093/bja/aes244.

Chipde S., Banjare M., Arora K., Saraswat M. Prospective randomized controlled comparison of caudal bupivacaine and ropivacaine in pediatric patients // Ann. Med. Health Sci. Res. — 2014 Jul. — 4(Suppl. 2). — S115-8. doi:10.4103/2141-9248.138025.

Coté C.J. Coté and Lerman’s a Practice of Anesthesia for Infants and Children. — 5th ed. — Philadelphia, PA: Elsevier/Saunders, 2013. — 990 р.

Ecoffey C., Lacroix F., Giaufré E., Orliaguet G., Courrè-ges P. Epidemiology and morbidity of regional anesthesia in children: a follow-up one-year prospective survey of the French-Language Society of Paediatric Anaesthesiologists (ADARPEF) // Paediatr. Anaesth. — 2010 Dec. — 20(12). — 1061-9. doi:10.1111/j.1460-9592.2010.03448.x.

Gregory A., Andropoulos D.B. Gregory’s Pediatric Anesthesia. — Chichester, West Sussex: Wiley-Blackwell, 2012.

Hadzic A. Textbook of Regional Anesthesia and Acute Pain Management. — New York: McGraw-Hill, Medical Pub. Division, 2007. — Chapter 54. Regional Anesthesia in Pediatric Patients.

Hebbard P., Fujiwara Y., Shibata Y., Royse C. Ultrasound-guided transversus abdominis plane (TAP) block // Anaesth. Intensive Care. — 2007 Aug. — 35(4). — 616-7. PubMed PMID:18020088.

Jöhr M. Practical pediatric regional anesthesia // Curr. Opin. Anaesthesiol. — 2013 Jun. — 26(3). — 327-32. doi:10.1097/ACO.0b013e3283606a1e.

Ko S., Goldstein D.H., VanDenKerkhof E.G. Definitions of «respiratory depression» with intrathecal morphine postoperative anal-gesia: a review of the literature // Can. J. Anaesth. — 2003 Aug-Sep. — 50 (7). — 679-88. doi:10.1007/BF03018710.

Koomen E., Janssen S., Anderson B.J. Use of ultrasound bladder monitoring in children after caudal anaesthesia // Paediatr. -Anaesth. — 2002 Oct. — 12(8). — 738-41. PubMed PMID:12472714.

Lacroix F. Epidemiology and morbidity of regional anaesthesia in children // Curr. Opin. Anaesthesiol. — 2008 Jun. — 21. — 345-9. doi:10.1097/ACO.0b013e3282ffabc5.

Metzelder M.L., Kuebler J.F., Glueer S., Suempelmann R., Ure B.M., Petersen C. Penile block is associated with less urinary retention than caudal anesthesia in distal hypospadia repair in children // World J. Urol. — 2010 Feb. — 28(1). — 87-91. doi:10.1007/s00345-009-0420-2.

Miller’s anesthesia / N. Cohen, R. Miller, L. Eriksson, L. Fleisher, J. Wiener-Kronish, W. Young. — Philadelphia: Elsevier/Saunders, 2015.

Naja Z.M., Raf M., El-Rajab M., Ziade F.M., Al Tannir M.A., Lönnqvist P.A. Nerve stimulator-guided paravertebral blockade combined with sevoflurane sedation versus general anesthesia with syste-mic analgesia for postherniorrhaphy pain relief in children: a prospective randomized trial // Anesthesiology. — 2005 Sep. — 103(3). — 600-5. PubMed PMID:16129986.

Naja Z.M., Raf M., El-Rajab M., Daoud N., Ziade F.M., Al-Tannir M.A., Lönnqvist P.A. A comparison of nerve stimulator guided paravertebral block and ilio-inguinal nerve block for analgesia after inguinal herniorrhaphy in children // Anaesthesia. — 2006 Nov. — 61(11). — 1064-8. PubMed PMID:17042844.

Niesters M., Overdyk F., Smith T., Aarts L., Dahan A. Opioid-induced respiratory depression in paediatrics: a review of case reports // Br. J. Anaesth. — 2013 Feb. — 110(2). — 175-82. doi:10.1093/bja/aes447.

Pappas A.L., Sukhani R., Hatch D. Caudal anesthesia and urinary retention in ambulatory surgery // Anesth. Analg. — 1997 Sep. — 85(3). — 706. PubMed PMID:9296439.

Polaner D.M., Taenzer A.H., Walker B.J., Bosenberg A., Krane E.J., Suresh S., Wolf C., Martin L.D. Pediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia // Anesth. Analg. — 2012 Dec. — 115(6). — 1353-64. doi:10.1213/ANE.0b013e31825d9f4b.

Rigg J.R., Jamrozik K., Myles P.S., Silbert B.S., Peyton P.J., Parsons R.W., Collins K.S.; MASTER Anaethesia Trial Study Group. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial // Lancet. — 2002 Apr 13. — 359(9314). — 1276-82. PubMed PMID:11965272.

Schultz-Machata A.M., Weiss M., Becke K. What’s new in pediatric acute pain therapy? // Curr. Opin. Anaesthesiol. — 2014 Jun. — 27(3). — 316-22. doi:10.1097/ACO.0000000000000074.

Seyedhejazi M., Sheikhzadeh D., Adrang Z., Rashed F.K. Comparing the analgesic effect of caudal and ilioinguinal iliohypogastric nerve blockade using bupivacaine-clonidine in inguinal surge-ries in children 2–7 years old // Afr. J. Paediatr. Surg. — 2014 Apr-Jun. — 11(2). — 166-9. doi:10.4103/0189-6725.132821.

Shanthanna H., Singh B., Guyatt G. A systematic review and meta-analysis of caudal block as compared to noncaudal regional techniques for inguinal surgeries in children // Biomed. Res. Int. — 2014. — 2014. — 890626. doi:10.1155/2014/890626.

Suresh S., Long J., Birmingham P.K., De Oliveira G.S. Jr. Are caudal blocks for pain control safe in children? an analysis of 18,650 caudal blocks from the Pediatric Regional Anesthesia Network (PRAN) database // Anesth. Analg. — 2015 Jan. — 120(1). — 151-6. doi:10.1213/ANE.0000000000000446.

Yarwood J., Berrill A. Nerve blocks of the anterior abdominal wall // Continuing Education in Anaesthesia, Critical Care and Pain. 2010;10:182–186. doi:10.1093/bjaceaccp/mkq035.




DOI: https://doi.org/10.22141/2224-0586.7.70.2015.78741

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