Chirurgie; mémoires de l'Académie de chirurgie
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Many regional anesthetic techniques can be used in the setting of abdominal surgery. Spinal anesthesia has limited indications for lower abdominal surgery (below T10), especially abdominal wall surgery and anal surgery. Indications of epidural anesthesia are quite similar, while epidural analgesia can be extensively used for postoperative analgesia, provided great attention is paid to strict monitoring and safety rules. Finally, peripheral regional anesthetic techniques are discussed, highlighting their advantages in this particular setting.
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Efficient and prolonged postoperative analgesia is obtained with regional anesthesia in pediatrics. Its wide use has been due to an easy performance in pediatrics with a success rate near 100% for the peripheral blocks, and to a minimal deleterious hemodynamic effect of the sympathetic block following an epidural anesthesia. Regional anesthesia in pediatrics have many indications and few contra-indications. In addition the risk of accidents is low and was observed mainly with perimedullar blocks.