Pediatric Regional Anesthesia
At the Center for Children’s Surgery (CCS) we offer a wide range of pediatric regional anesthesia techniques performed by board-certified pediatric anesthesiologists. We work closely with our surgical colleagues to develop anesthetic plans unique to each child. The goal of regional anesthesia is to keep your child as comfortable and safe as possible while enhancing their ability to heal after surgery.
What is Regional Anesthesia?
Regional anesthesia is a type of pain management technique that anesthetizes or numbs a specific part of the body. This is typically accomplished by injecting numbing medicine near the nerves that supply sensation to the desired part of the body. Regional anesthesia includes nerve blocks, epidurals, and spinals. In pediatric patients, regional anesthesia is typically performed while they are sedated or under general anesthesia.
The regional anesthesia team is an integral part of pediatric Enhance Recovery After Surgery (E.R.A.S.) protocols. Pediatric E.R.A.S. is a protocol used during the perioperative period to ensure patients have the best possible outcome. One of the components of the protocol is to utilize opioid-sparing strategies that focus on regional anesthesia techniques.
Guidelines from the Society for Pediatric Anesthesia:
“…clinicians should use all methods possible to minimize the use of opioids… Use of nonopioid analgesia is encouraged including regional analgesia techniques…”
If a regional anesthetic technique is indicated for your child, an anesthesiologist will speak with you, discuss the options, explain what to expect and answer any questions.
We follow the guidelines set by the Society for Pediatric Anesthesia (SPA), the American Society of Regional Anesthesia and Pain Medicine (ASRA), and the American Society of Anesthesiologists (ASA).
We look forward to meeting you and your child.
Director, Pediatric Regional Anesthesia
Pediatric Regional Anesthesia FAQsExpand all
What is regional anesthesia?
Regional anesthesia is a type of pain management technique that anesthetizes or numbs a specific part of the body. This is typically accomplished by injecting numbing medicine near the nerves that supply sensation to the desired part of the body. Regional anesthesia includes nerve blocks, epidurals and spinals. In pediatric patients regional anesthesia is typically performed while they are sedated or under general anesthesia.
Is regional anesthesia safe for kids and babies?
Regional anesthesia has been safely performed in pediatric patients for many years at institutions around the world. All procedures carry a level of risk. One of our board-certified pediatric anesthesiologists will discuss the risks and benefits specific to your child on or before the day of surgery. One of the differences for pediatric patients as compared to adult patients is that regional anesthesia blocks are typically performed under sedation or general anesthesia. The safety of this practice has been confirmed with data from the Pediatric Regional Anesthesia Network (PRAN). The PRAN network was established in 2007 to study regional anesthesia in infants and children. It has grown to include 21 centers with data from over 100,000 pediatric patients. This database provides benchmarking data for practitioners across North America and around the world.
Is regional anesthesia performed when my child is awake or sedated?
What is a nerve block?
A nerve block is performed by injecting numbing medicine near a nerve to block pain in a specific part of the body. This can be performed as a single injection or a small catheter can be left in place. The catheter is then used to administer numbing medicine during and after surgery. Nerve block catheters can be left in place for about 3-5 days depending on the location and type of procedure performed.
What is an epidural?
An epidural is a type of regional anesthesia where medication is injected into the epidural space. This differs from a spinal block where medication is injected into the spinal space. An epidural can be performed as a single injection or a small catheter can be left in place. The catheter is used to administer medicine during and after the surgery to keep the patient as comfortable as possible. A common type of single-injection epidural block performed in pediatric patients is a caudal block.
What is a caudal block?
A caudal block is a type of regional anesthesia where medicine is injected into the caudal space. This is a type of epidural block that takes advantage of the unique anatomy of babies and toddlers, the sacral hiatus. The sacral hiatus is an opening in the tailbone formed by the incomplete fusion of the sacral vertebrae. This block is most often performed as a single injection but a small catheter can be left in place to continue the administration of pain medication.
What is a spinal?
A spinal block, also called a subarachnoid block, is a type of regional anesthesia where medication is injected around the spinal cord. This is typically a single injection and no catheter is left in the patient.