A review of more than 15,000 nerve block procedures performed in children at U.S. hospitals finds little or no risk of permanent complications or death, reports a study in the December issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).
"Regional anesthesia in children as commonly performed in the United States has a very low rate of complications," write Dr David M. Polaner of Children's Hospital Colorado, Aurora. At a time of increasing use of regional anesthesia, the study provides reassurance that nerve block procedures are safe for anesthesia or pain control in children.
No Serious Complications of Regional Nerve Blocks
The researchers used a nationwide anesthesiology database, the Pediatric Regional Anesthesia Network, to collect detailed information on regional anesthesia procedures in children, including any complications during and after surgery. The data were "rigorously audited" to identify and correct errors and to ensure that all regional anesthetics performed at the participating hospitals were included.
Regional anesthesia provides a useful approach to anesthesia during surgery or pain control after surgery. As opposed to general anesthesia where the patient inhales an anesthetic gas, regional anesthesia consists of injections of anesthetic drugs around specific nerves to "block" sensation in that part of the body.
The review identified nearly 15,000 regional anesthesia procedures performed between 2007 and 2010. About 11,000 procedures consisted of a single anesthetic injection. The rest were "continuous block" procedures, with insertion of a catheter near the nerve for repeated anesthetic injections.
Although risk varied by the type and location of nerve block, overall complication rates were low. Most importantly, there were no deaths or serious complications leading to permanent injury. For single-injection procedures, the most common complication was inability to place the block or block failure—two percent of the total.
Continuous block procedures had a higher complication rate—most commonly problems in catheter placement (such as kinking or dislodgement). In this group, the block failure rate was nine percent.