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Anästhesiol Intensivmed Notfallmed Schmerzther 2013; 48(4): 272-277
DOI: 10.1055/s-0033-1343763
Fachwissen
Topthema: Kinderanästhesie
© Georg Thieme Verlag Stuttgart · New York

Kinderanästhesie – Regionalanästhesie bei Kindern: Kaudalanästhesie und Bauchwandblockaden

Regional anaesthesia in children –caudal anaesthesia and trunk blocks
Jakobea Benz-Wörner
,
Martin Jöhr
Further Information

Publication History

Publication Date:
30 April 2013 (online)

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Zusammenfassung

Elektive Eingriffe bei Kindern betreffen oft die Abdominal- oder Leistenregion. Regionalanästhesieverfahren ermöglichen eine gute Analgesie bei reduzierter Opioidgabe und begünstigen eine raschere Entlassung der kleinen Patienten. In dieser Übersicht besprechen wir Indikation, Anatomie, Punktionstechnik und potenzielle Komplikationen von Kaudalanästhesie, Transversus-Abdominis-Plane-Blockade, Ilioinguinalis-/Iliohypo-gastrikus-Blockade und Rektusscheidenblock.

Abstract

In children, elective surgery is often performed in the trunk region. Regional anaesthetic techniques allow good analgesia with reduced opioid consumption, and enhance rapid discharge of the small patients. This review focuses on indication, anatomic structures, puncture techniques and potential complications of caudal anaesthesia, transversusabdominis plane block, ilioinguinal/iliohypogastric nerve block and rectus sheath block.

Kernaussagen

  • Die Kaudalanästhesie ist ein Standardverfahren für Eingriffe unterhalb des Nabels im Vorschulalter.

  • Eine adrenalinhaltige Testdosis hilft, bei der Kaudalanästhesie eine intravasale Nadellage rechtzeitig zu erkennen.

  • Der ultraschallgesteuerte medioaxilläre Transversus-Abdominis-Plane-Block (TAP-Block) ermöglicht eine Analgesie der Bauchwand für Eingriffe unterhalb des Nabels.

  • Der TAP-Block führt zu hohen systemischen Lokalanästhetikaspiegeln.

  • Der Ultraschalleinsatz für die Ilioinguinalis- /Iliohypogastrikus-Blockade ermöglicht im Vergleich zur landmarkenbasierten Technik eine deutlich höhere Erfolgs- und geringere Komplikationsrate.

  • Der ultraschallgesteuerte Rektusscheidenblock ermöglicht eine gute Analgesie für Eingriffe im Nabelbereich.

Schlüsselwörter:

Kaudalanästhesie - Transversus-Abdominis-Plane-Blockade - Ilioinguinalis-/Iliohypogastrikus-Blockade - Rektusscheidenblock

Keywords:

caudal anaesthesia - transversusabdominis plane block - ilioinguinal/iliohypogastric nerve block - rectus sheath block.

Ergänzendes Material

 

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