Regional anesthesia

Abstract

Regional anaesthesia, although technically challenging in neonates, has wide ranging benefits. Effective pain relief after surgery plays a significant role in the surgical outcome. Most major surgery is performed within the first few days of life-a time when critical physiological transitions are taking place. The challenge is to provide safe and effective analgesia. Although it may not be possible to completely eliminate postoperative pain, particularly in spontaneously breathing neonates, much can be done to reduce the intensity of pain. Traditionally intravenous morphine or other opioids are used, but these mandate ventilatory support and close monitoring in a neonatal intensive or similar high care unit. In contrast, regional anaesthesia comes closest to achieving complete analgesia in both ventilated and spontaneously breathing neonates.