The regional anesthesia for surgical correction of the malformation of upper extremities in pediatric

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Abstract

The article presents an analysis of the publications devoted to the problems of anesthesia to surgical procedures at the malformations of the upper extremity in children. The article reviews the questions of epidemiology, classification of upper extremity malformation, safety of anesthesia and the role of regional blockades in the structure of intraoperative and postoperative analgesia to surgical procedures at the malformations of the upper extremity in children. Children are more likely than adults to experience stress in the operating room and early postoperative period. Children are almost impossible to prepare psychologically for the upcoming anesthesia, surgical intervention, a sense of pain after it. Surgical correction of malformations of the upper limbs in children is characterized by multistage and high traumatism, which requires the search for adequate methods of anesthesia, capable of ensuring not only the absence of pain, but also the negative impact on the nervous system of little patients. The key to the application of regional anesthesia in young children is the need for sedation or general anesthesia. The use of ultrasound navigation and electrostimulation of peripheral nerves significantly increases the level of safety and success of their realization. At present, the questions about the duration of postoperative analgesia with the use of peripheral nerve blocks and the need for additional anesthesia in the early postoperative period have been little studied. The influence of the applied anesthesia technique on the state of young children in the postoperative period are requires further investigation.

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Julia A. Manokhina

Regional Children's Clinical Hospital No 1

Author for correspondence.
Email: farm.rao@gmail.com

dr. anesthesiologist, Department of Anaesthesiology and Reanimation No 1

Russian Federation, Ekaterinburg

References

  1. Айзенберг В.Л., Ульрих Г.Э., Цыпин Л.Е., Заболотский Д.В. Регионарная анестезия в педиатрии. – СПб.: Синтез Бук, 2011. – 303 c. [Ayzenberg VL, Ul’rikh GE, Tsypin LE, Zabolotskiy DV. Regional anesthesia in pediatric patients. Saint Petersburg: Sintez Buk; 2011. 303 p. (In Russ.)]
  2. Айзенберг В.Л., Цыпин Л.Е., Михельсон В.А., Блаженов М.Б. Регионарные анестезии у детей — концепция, преимущества и общие принципы // Анестезиология и реаниматология. – 1998. – № 1. – С. 22–24. [Ayzenberg VL, Tsypin LE, Mikhel’son VA, Blazhenov MB. Regional anesthesia in children — concept, benefits and general principles. Anesteziologiya i reanimatologiya. 1998;(1):22-24. (In Russ.)]
  3. Александрова О.В., Девайкин Е.В. Сравнительная оценка эффективности блокады плечевого сплетения в зависимости от варианта верификации нервов у детей раннего возраста // Гений ортопедии. – 2014. – № 2. – С. 60–63. [Aleksandrova OV, Devaykin EV. Comparative evaluation of brachial plexus block efficiency depending on the variant of nerve verification in infants. Geniy ortopedii. 2014;(2):60-63. (In Russ.)]
  4. Александрова О.В. Сравнительная оценка общей и проводниковой анестезии при хирургической коррекции врожденных деформаций кисти у детей раннего возраста: Автореф. дис. … канд. мед. наук. – Екатеринбург, 2015. [Aleksandrova OV. Comparative evaluation of general and conductive anesthesia in surgical correction of congenital deformities of the hand in children of early age. [dissertation] Ekaterinburg; 2015. (In Russ.)]
  5. Алпатов В.Н. Сроки и методы лечения врожденной патологии кисти у детей // Дет. хирургия. – 2002. – № 6. – С. 21–24. [Alpatov VN. Terms and methods of treatment of congenital pathology of the hand in children. Det. khirurgiya. 2002;(6):21-24. (In Russ.)]
  6. Биккулова Д.Ш. Боль и эмоции у детей в хирургической клинике. – Уфа, 2005. – 136 с. [Bikkulova DSh. Pain and emotions in children in a surgical clinic. Ufa; 2005. 136 p. (In Russ.)]
  7. Волков М.В. Костная патология детского возраста. – М.: Медицина, 1968. – 496 с. [Volkov MV. Pathology of bones in children. Moscow: Meditsina; 1968. 496 p. (In Russ.)]
  8. Волков М.В. Ортопедия и травматология детского возраста. – М.: Медицина, 1983. – 464 с. [Volkov MV. Orthopedics and traumatology in children. Moscow: Meditsina; 1983. 464 p. (In Russ.)]
  9. Гаряев Р.В. Концепция анальгезии при использовании регионарных методов обезболивания // Регионарная анестезия и лечение острой боли. – 2013. – Т. 7. – № 2. – С. 39–47. [Garyaev RV. The concept of analgesia for using regional anesthesia. Regionarnaya anesteziya i lechenie ostroy boli. 2013;7(2):39-47. (In Russ.)]
  10. Дедух Н.В., Хмызов С.А., Подлипенцев В.В., Тихоненко А.А. Врожденные аномалии конечностей (обзор литературы) // Ортопедия, травматология и протезирование. – 2013. – № 2. – С. 102–108. [Dedukh NV, Khmyzov SA, Podlipentsev VV, Tikhonenko AA. Congenital anomalies of extremities (review article). Ortopediya, travmatologiya i protezirovanie. 2013;(2):102-108. (In Russ.)]
  11. Заболотский Д.В., Голяна С.И., Зайцева Н.В., и др. Анестезия при микрохирургической аутотрансплантации пальцев стопы на кисть у детей с врожденной посттравматической патологией // Травматология и ортопедия России. – 2010. – № 1. – С. 43–47. [Zabolotskiy DV, Golyana SI, Zaytseva NV, et al. Anesthesia for microsurgical autotransplantation of toes on the wrist in children with congenital and posttraumatic pathology. Travmatologiya i ortopediya Rossii. 2010;(1):43-47. (In Russ.)]
  12. Загреков В.И. Неингаляционная анестезия при операциях на верхних конечностях: Автореф. дис. … канд. мед. наук. – Саратов, 1997. [Zagrekov VI. Non-Inhalation anesthesia on operations on the upper limbs. [dissertation] Saratov; 1997. (In Russ.)]
  13. Захаров Е.В., Девайкин Е.В., Свалов А.И. Плексусная анестезия в сочетании с медикаментозной седацией у детей раннего возраста с ортопедической патологией с позиции адекватности анестезиологической защиты // Уральский медицинский журнал. – 2007. – № 6. – С. 75–78. [Zakharov EV, Devaykin EV, Svalov AI. Plexus anesthesia in combination with drug sedation in children of early age with orthopedic pathology from the standpoint of adequacy of anesthetic protection. Ural’skiy meditsinskiy zhurnal. 2007;(6):75-78. (In Russ.)]
  14. Круподёров Д.А., Пивоваров С.А., Острейков И.Ф., и др. Изменения гемодинамики при применении регионарной анестезии и медикаментозной седации в детской травматологии // Анестезиология и реаниматология. – 2004. – № 1. – С. 39–42. [Krupoderov DA, Pivovarov SA, Ostreykov IF, et al. Changes of hemodynamics with the application of regional anesthesia and drug sedation in pediatric traumatology. Anesteziologiya i reanimatologiya. 2004;(1):39-42. (In Russ.)]
  15. Лекманов А.У., Суворов С.Г., Розанов Е.М., и др. Современные подходы к выбору метода анестезиологического пособия у детей // Анестезиология и реаниматология. – 2002. – № 1. – С. 12–14. [Lekmanov AU, Suvorov SG, Rozanov EM, et al. Modern approaches to the choice of the method of anesthesia in children. Anesteziologiya i reanimatologiya. 2002;(1):12-14. (In Russ.)]
  16. Лешкевич А.И., Ражев С.В., Михельсон В.А., Сидоров В.А. Продленная блокада плечевого сплетения аксиллярным доступом у детей // Анестезиология и реаниматология. – 1999. – № 4. – С. 41–44. [Leshkevich AI, Razhev SV, Mikhel’son VA, Sidorov VA. Extended blockade of the brachial plexus with axillary access in children. Anesteziologiya i reanimatologiya. 1999;(4):41-44. (In Russ.)]
  17. Майер Г., Бюттнер Й. Периферическая регионарная анестезия: пер. с англ. под ред. П.Г. Камчатнова. – 2-е изд., испр. – М.: БИНОМ. Лаборатория знаний, 2015. – 206 с. [Mayer G, Byuttner Y. Peripheral regional anesthesia. Ed by P.G. Kamchatnov. Moscow: BINOM. Laboratoriya znaniy; 2015. 206 p. (In Russ.)]
  18. Маковская А.А. Проводниковая анестезия при реплантации мелких сегментов конечности у детей // Медицинские новости. – 2000. – № 12. – С. 60–62. [Makovskaya AA. Conduction anesthesia in the re-implantation of small limb segments in children. Meditsinskie novosti. 2000;(12):60-62. (In Russ.)]
  19. Малыкин К.А., Анисимов О.Г. Периферические блокады у детей при операциях на верхних и нижних конечностях с использованием нейростимулятора // Казанский медицинский журнал. – 2003. – Т. 84. – № 5. – С. 354–359. [Malykin KA, Anisimov OG. Peripheric blockades in children during operations on upper and lower extremities performed with neurostimulator. Kazanskiy meditsinskiy zhurnal. 2003;84(5):354-359. (In Russ.)]
  20. Морозова Л.Н., Степаненко С.М. Межлестничная блокада при операциях на ключице у детей // Регионарная анестезия и лечение острой боли. – 2008. – Т. 2. – № 2. – С. 19–25. [Morozova LN, Stepanenko SM. Interscalen block for operations on the collarbone in children. Regionarnaya anesteziya i lechenie ostroy boli. 2008;2(2):19-25. (In Russ.)]
  21. Надирадзе З.З., Михайлов А.В., и др. Проведение блокады плечевого сплетения под контролем ультразвуковой визуализации и нейростимуляции // Бюллетень ВСНЦ СО РАМН. – 2014. – № 3. – С. 46–50. [Nadiradze ZZ, Mikhaylov AV, et al. Conducting brachial plexus blockade under control of ultrasound imaging and neurostimulation. Byulleten’ VSNTs SO RAMN. 2014;(3):46-50. (In Russ.)]
  22. Икласова Ф.Б. Частота развития послеоперационного делирия у детей после колопроктологических оперативных вмешательств // Медицина (Алматы). – 2017. – № 4. – С. 157–158. [Iklasova FB. The incidence of postoperative delirium in children after coloproctological surgical interventions. Medicina (Almaty). 2017;(4):157-158. (In Russ.)]
  23. Ульрих Г.Э., Заболотский Д.В. Послеоперационное обезболивание у детей. Какие стандарты нам использовать? // Регионарная анестезия и лечение острой боли. – 2015. – Т. 9. – № 2. – С. 40–45. [Ulrich GE, Zabolotsky DV. Postoperative analgesia in children. What standards should we use? Regionarnaya anesteziya i lechenie ostroy boli. 2015;9(2):40-45. (In Russ.)]
  24. Уорик Д., Данн Р., Меликян Э., Ведер Д. Хирургия кисти / Пер. с англ. под ред. Л.А. Родомановой. – М.: Изд. Панфилова БИНОМ: Лаборатория знаний, 2013. – 704 c. [Uorik D, Dann R, Melikyan E, Veder D. Surgical of the hand. Ed by L.A. Rodomanova. Moscow: Izd. Panfilova BINOM: Laboratoriya znaniy; 2013. 704 p. (In Russ.)]
  25. Allegri M, et al. Italian registry of complications associated with regional anesthesia (RICALOR): an incidence analysis from a prospective clinical survey. Minerva anestesiologica. 2016;82(4):392-402.
  26. Amiri HR, Espandar R. Upper extremity surgery in younger children under ultrasound-guided supraclavicular brachial plexus block: a case series. J Child Orthop. 2011;5(4):313. doi: 10.1007/s11832-011-0353-3.
  27. Duchicela S, et al. Pediatric Nerve Blocks: An Evidence-Based Approach. Pediatric Emergency Medicine Practice. 2013;10(10):1-20.
  28. Ecoffey C, Lacroix F, Giaufre E, et al. Epidemiology and morbidity of regional anesthesia in children: a follow-up one-year prospective survey of the French-Language Society of Paediatric Anaesthesiologists (ADARPEF). Paediatric Anaesth. 2010;20(12):1061-1069. doi: 10.1111/j.1460-9592.2010.03448.x.
  29. Felferniq M, et al. Use of ropivacaine and lidocaine for axillary plexus blockade. Afr J Paediatr Surq. 2010;7(2):101-104. doi: 10.4103/0189-6725.62860.
  30. Froster UG. Congenital defects of the upper limbs and associated malformations: a population based study. Am J Med Genet. 1992;44:767-781. doi: 10.1002/ajmg.1320440611.
  31. Giaufre E, Dalens B, Gombert A. Epidemiology and morbidity of regional anesthesia in children: a one-year prospective survey of the French-Language Society of Pediatric Anesthesiologists. Anesthesia and Analgesia. 1996;83:904-912. doi: 10.1213/00000539-199611000-00003.
  32. Gurnaney H, et al. Safety of pediatric continuous interscalene block catheters placed under general anesthesia: a single center’s experience. Acta Anaesthesoil Scand. 2015;59(3):377-383. doi: 10.1111/aas.12471.
  33. Harshad G, et al. Anesthetic management of the first pediatric bilateral hand transplant. J Can Anesth. 2016;63:731-736. doi: 10.1007/s12630-016-0625-y.
  34. Litke J, et al. Perioperative stress in children — anaesthesia and postoperative period. Anaesthesiology Intensive Therapy. 2012;44(3):170-174.
  35. Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain. 2008;137:473-477. doi: 10.1016/j.pain.2008.04.025.
  36. Marhofer P, Sitzwohl C, Greher M, et al. Ultrasound guidance for infraclavicular brachial plexus anaesthesia in children. Anaesthesia. 2004;59(7):642-646. doi: 10.1111/j.1365-2044.2004.03669.x.
  37. Memtsoudis SG, Kuo C, et al. Changes in anesthesia related factors in ambulatory knee and shoulder surgery: United States 1996-2006. Req Anesth Pain Med. 2011;36(4):327-331. doi: 10.1097/AAP.0b013e318217703c.
  38. Pande R, Pande M, et al. Supraclavicular brachial plexus block as a sole anaesthetic technique in children: an analysis of 200 cases. Anaesthesia. 2000;55(8):798-802. doi: 10.1046/j.1365-2044.2000.01330.x.
  39. Polaner DM, Taenzer AH, Walker BJ, et al. Pediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia. Anesth Analg. 2012;115(6):1353-64. doi: 10.1213/ANE.0b013e31825d9f4b.
  40. Rhalil A, Pajkit E, Chity LS. Eearly prenatal diagnoses of skeletal anomalies. Prenatal Diaq. 2011;31(1):115-24. doi: 10.1002/pd.2676.
  41. Roberts S. Ultrasonographic guidance in pediatric regional anesthesia. Part 2: techniques. Paediatr Anaesth. 2006;16:1112-24. doi: 10.1111/j.1460-9592.2006.02021.x.
  42. Suresh S, Birmingham PK, Kozlowski RJ. Pediatric pain management. Anesthesiol Clin. 2012;30(1):101-117. doi: 10.1016/j.anclin.2011.12.003.
  43. Tolba R, Badr R, Guirguis M, Soliman LM. Pediatric continuous brachial plexus catheter for a case of complex regional pain syndrome (CRPS). Open Journal of Anesthesiology. 2015;5:1-6. doi: 10.4236/ojanes.2015.51001.
  44. Veneziano G, Betran R, Bhalla T, et al. Peripheral regional anesthesia in infants and children: an update. Anesth Pain and Intensive Сare. 2014;18(1):59-71.
  45. Vicchio N, et al. Evaluation of 18279 Blocks in a Pediatric Hospital. Anesth Pain Med. 2015;5(2):1-2. doi: 10.5812/aapm.22897.
  46. Visoiu M. The effectiveness of ambulatory continuous peripheral nerve blocks for postoperative pain management in children and adolescents. Paediatr Anaesth. 2014;24(11):1141-1148. doi: 10.1111/pan.12518.
  47. http://www.eurocat-network.eu/prenatalscreeninganddiagnosis/prenataldetection(pd)rates (accessed 25.04.2017).
  48. http://www.ifssh.info/2015_OMT_Classifiction_Congenital_Report.pdf (accessed 25.04.2017).

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