European journal of anaesthesiology
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Regional anaesthesic techniques are commonly used for the management of pain following lower abdominal surgery in children. The transversus abdominis plane (TAP) block has shown promise for perioperative analgesia, but data on the optimal dose regimen are limited. ⋯ As part of a multimodal analgesia strategy, ultrasound-guided TAP block with 0.2 ml kg(-1)of 0.2% levobupivacaine provides successful peroperative analgesia in 95% of children who underwent herniorrhaphy.
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Thoracolumbar paravertebral block (PVB) is one method of providing regional anaesthesia for abdominal wall surgery in children. It is common practice when performing a PVB for abdominal wall anaesthesia to inject a certain volume of local anaesthetic solution in the paravertebral space at several levels. This increases the duration of the procedure and makes it more invasive. ⋯ Single thoracolumbar paravertebral injection at T12-L1 level leads to caudad and cephalad spread of injectate in a dose-dependent manner. Single injection thoracolumbar paravertebral injections could be performed for lower abdomen anaesthesia in infants. We suggest that a single injection of 0.2 to 0.3 ml kg(-1) of local anaesthetic in the thoracolumbar paravertebral space could provide adequate coverage of the dermatomes of the lower abdomen.
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Letter Case Reports
Anaesthesia and orphan disease: Haddad syndrome (Ondine-Hirschsprung disease).