Regional anesthetic techniques for the pediatric patient

Abstract

In the hospital setting, effective treatment of acute pain in children is a high priority as clinical studies have shown pediatric patients experience pain from medical illnesses, during therapeutic and diagnostic procedures, and from trauma and surgery [1–3]. Although opiates can be safely administered to children, the elimination half-life in newborns is observed to be longer, and clearance is decreased when compared to older children and adults [4]. The optimal plasma concentration for effective analgesia is highly variable, requiring careful titration to obtain the desired level of analgesia while minimizing side effects [5–7]. Moreover, these observed differences are particularly pronounced in the preterm neonate as opiates, such as morphine, are less protein bound which allows greater penetration into the immature blood-brain barrier and increases the risk for respiratory depression [7–10].