Need

This book addresses the need to encourage the use, and improve the performance, of regional anesthesia using ultrasound in children.

There are few resources available, either in print and online, that specifically focus on the use of ultrasound in pediatric regional anesthesia practice.

This book has been conceived with the practicing anesthesiologist in mind. The editors determined that a practical, user-friendly book would be an excellent tool to encourage and improve the use of ultrasound in pediatric regional anesthesia. They have assembled an international group of authors who have written this up-to-date guide on specific ultrasound-guided blocks.

Other users, such as emergency doctors, pain specialists, nurse anesthetists, and medical students, may also find this book useful.

Practical

This book consists of two parts. The first part contains five chapters dedicated to the principles and practice of ultrasound use for regional anesthesia in children.

These chapters address in detail the challenges and issues described previously and include the performance of regional anesthesia in children, the pharmacology of LAs in children, the “nuts and bolts” of ultrasonography, managing safety and complications, and providing a description of the relevant clinical anatomy to allow interpretation of the sonoanatomy for each nerve block. These chapters should be read before performing any block, as the principles and practices necessary for safe regional anesthesia in children are described in detail and are not repeated in the “block” chapters.

The second part consists of 15 chapters, each describing the performance of a nerve block using ultrasound. Each “block” chapter will introduce the nerve block and describe its clinical uses and the current literature on the use of ultrasound for that block. The chapter will provide a practical “how-to-do” section on performing that block, including relevant sonoanatomy, patient and probe position, needle placement, and block performance. The reader should note that static ultrasound images are not fully representative of scanning in practice. The dynamic imaging obtained by subtle tilting and translation of the probe results in better resolution images in real-time. Therefore, the sonoanatomy has been labeled to assist with anatomic identification, and where necessary for quality purposes, a needle pathway has been highlighted as for some blocks the needle images were faint, poor, or unclear. Finally a section on clinical tips is provided, where applicable, from the clinical experiences of the authors.

Each chapter has a suggested reading list including references from the text as well as resources that provide further information for interested readers.

Some readers may be disappointed by the apparent omission of certain nerve blocks. Examples of techniques where ultrasound guidance can be used include penile and psoas compartment blocks. The non-inclusion of a particular block does not diminish its clinical usefulness; we have chosen the nerve blocks for this book based on their clinical application, common usage, and/or innovative nature.

Conclusion

The safe and effective practice of regional anesthesia in children requires in-depth knowledge and supervised training. This book in isolation will not make you an expert in pediatric ultrasound-guided regional anesthesia. It will, we hope, assist you in developing and expanding your skills and knowledge base and facilitate the application of regional anesthesia to your everyday pediatric practice.