INTRODUCTION OF CONTINUOUS REGIONAL TECHNIQUES FOR POSTOPERATIVE PEDIATRICS PATIENTS - ONE YEARS EXPERIENCE FROM 2 HOSPITALS

Aim. To review the use, safety and efficacy of continuous regional tec hniques in children and neonates. Methods. The records of all children who received postoperative continuous regional analgesic techniques d uring the year 1992 at the Starship Children's Hospital and Waikato Ba se Hospital were reviewed. In both post operative care units orders, p rocedures and protocols were standardised. Results. A total of 80 chil dren received these techniques. Patients were cared for in high depend ency nursing areas. The two techniques used were epidural and interple ural analgesia. Epidural: The majority (68) had epidural catheters and of these 13 infants were in their first month of life. Major problems occurred in six (9%) of children receiving epidurals - two blocks fai led completely, two suffered subarachnoid puncture, one had respirator y depression and one developed a foot-drop. The blockade failure and s ubarachnoid punctures occurred early in the establishment of paediatri c epidural analgesic services. Minor problems included the necessity f or morphine supplementation in three (4%) children, leaks about the ca theter in seven (10%), nausea and vomiting in six (9%), two (3%) devel oped pruritus and one block was ceased because of concerns expressed a bout masking symptoms of compartmental compression. Interpleural: twel ve patients were treated with this technique. One neonate suffered a c onvulsion. Conclusion. Major continuous regional techniques in paediat ric patients are effective, but because of potential complications, th ere is a requirement that these blocks be performed, monitored and car ed for by staff experienced and trained with these procedures.