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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
COSTA, Verônica Vieira da; RODRIGUES, Mônica Rossi; FERNANDES, Maria do Carmo Barretto de Carvalho and SARAIVA, Renato Ângelo. Neurological complications and damage of regional block in children under general anesthesia: a real problem or sporadic cases?. Rev. Bras. Anestesiol. [online]. 2006, vol.56, n.6, pp. 583-590. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942006000600003.
BACKGROUND AND METHODS: It has been questioned whether regional block in children, which most of the time is done under general anesthesia, is really safe. There is the potential risk of permanent or temporary neurological damage when the patient cannot complain of eventual paresthesia or pain while the block is being performed, making anesthesiologists very insecure. The aim of this study was to evaluate the prevalence of neurological complications and damage of regional block in children under general anesthesia. METHODS: A prospective analysis of children who underwent orthopedic and reconstructive plastic surgeries under regional block associated with general anesthesia was undertaken. Anesthesia was induced and maintained by the intravenous or inhalational route. Regional block was done after general anesthesia and immediate complications, number of punctures, mean term complications, and the presence of neurological damage were evaluated. RESULTS: Four hundred and forty-nine children, boys and girls, with a mean age of 6,7 years, were evaluated over a 13-month period. The majority of the patients underwent general anesthesia associated with epidural lumbar or caudal block. The prevalence of immediate complications was 3.6% and bleeding at the time of the puncture was the most frequent complication. The prevalence of average term complications was 1.1%, and hyposthesia was the most frequent complication. There was no long-term neurological damage. CONCLUSIONS: The results of this study are similar to those found by other authors regarding the low prevalence of complications of regional block in children under general anesthesia, without the occurrence of permanent neurological damage. This can be attributed to the use of adequate material and the experience of the anesthesia team
Keywords : ANESTHESIA, Pediatric; ANESTHETIC TECHNIQUES, Regional [caudal]; ANESTHETIC TECHNIQUES, Regional [lombar]; ANESTHETIC TECHNIQUES, Regional [epidural]; COMPLICATIONS [neurological injury].