Paediatric regional anaesthesia: new developments and improving accuracy

Regional anaesthesia can provide absolute pain relief without the risks of opiate-induced respiratory depression. The purpose of this paper is to (i) provide insight into some new techniques that may improve the success and accuracy of peripheral nerve blocks, with particular reference to the role of nerve mapping, nerve stimulators and portable ultrasound; (ii) introduce methods to reduce the risk of intraneural injection; (iii) suggest methods to prolong the analgesia provided by peripheral nerve blocks, i.e. continuous peripheral nerve catheters appropriate for use in children; and (iv) propose methods to manage local anaesthetic toxicity, with particular reference to the use of intralipid solutions.