Peripheral and local anaesthetic techniques for paediatric surgery

Peripheral nerve blocks (PNBs) in paediatric patients are usually used as an adjunct to general anaesthesia, providing intra- and postoperative pain relief. These blocks provide good-quality analgesia and have opioid-sparing effects, preventing morbidity related to pain. PNBs aid early patient recovery and discharge, which is essential in day-case surgery. Like all invasive techniques, PNBs are associated with complications and side-effects. They should therefore be performed only after careful analysis of the risk:benefit ratio for each child. This article discusses a general approach to PNBs in children. It covers a small selection of limb and trunk blocks, and introduces the benefit of ultrasound guidance.