الفهرس 
Physiological Differences between Pediatrics and Adults as Regard Regional AnesthesiaOnly 14 pages are availabe for public view
 |  | from | 128 |  |  |
| | | from | 128 | | |
Abstract
The practice of pediatric regional anesthesia is several millenniums old. An Egyptian sculpture of Saqqarah, carved about 2500 BC, shows a scene of circumcision in which an object-“The Stone of Memphis” appears to be employed for inducing anesthesia of the penis before operation. The later civilizations turned away from these traditional analgesic practices until the end of the nineteenth and the beginning of the twentieth centuries. (Dalens Bernard; 1989)
Regional anesthesia has become an essential part of pediatric anesthesia and, in many instances, represents the best option to provide intraoperative and postoperative pain relief in children whatever their ages and associated medical conditions. The increasing sophistication of medical treatments, the growing number of pediatric patients in poor physical condition scheduled for emergency as well as elective surgeries, and the constant improvement of general anesthetic techniques occasionally raise some questions concerning the benefit/ risk ratio of regional anesthetic techniques compared with that of other techniques of analgesia. (Lippincott Williams and Wilkins; 2006)
Epidural analgesia has many beneficial effects in the pediatric patient population. In clinical practice, it is commonly used to augment general anesthesia and to manage postoperative pain. Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, rapid weaning from ventilators, reduced time spent in a catabolic state and lowered circulating stress hormone levels (Henderson et al; 2008)
Spinal anesthesia in pediatrics is most commonly used in the preterm infant undergoing anesthesia for hernia repair. Spinal anesthesia can also be used effectively in children for postoperative pain relief especially if opioids are used (Tobias; 2000)
The use of peripheral nerve blocks has been regaining significant popularity in the daily practice of most anesthesiologists. Despite the trend towards increase in the use of regional anesthesia and nerve blocks in adults, peripheral nerve blocks in children remain underutilized. (Ivani and Tonetti; 2004).