UGRA in pedriatric anesthesia

Slides:

Advertisements

Similar presentations

SPINAL,EPIDURAL/CAUDAL,PENILE NERVE BLOCK IN PEDIATRIC PATIENTS

Advertisements

Regional Anesthesia in the Outpatient Setting Ravindra V. Prasad, MD Department of Anesthesiology UNC School of Medicine.

Segmental Thoracic Spinal Anesthesia

Dermatome Levels Soli Deo Gloria

Ian Smith, MD, FRCA Editor, Journal of One-day Surgery Senior Lecturer in Anaesthesia University Hospital of North Staffordshire Stoke-on-Trent ASA III.

Evidence Based Medicine in Peri-operative Care Wimonrat Sriraj M.D. Department of Anesthesiology, Faculty of Medicine, Khon Kaen University Phuket17/07/2008.

Combined Spinal Epidural Anesthesia EMELITA A. UMALI, MD, FPBA.

Safe pediatric anesthesia

Anesthetic Agent Exposure New Concerns of Adverse Impact Scott D. Kelley, M.D.  Conflict of Interest Statement  Employee and Officer of Aspect Medical.

VTE Prophylaxis Alert to providers and nursing Go live June 24, 2014.

Jen Sackrison Anesthesia Clerkship 9/2/11

Development of a Registry of Regional Anaesthesia - the AURORA study St Vincent’s Hospital, Melbourne Dr Michael Barrington St Vincent’s Hospital, Melbourne.

Maria Matuszczak MD Professor of Anesthesiology Division Chief Pediatric Anesthesia 6 th Anesthesia And Critical Care Conference Kuwait Nov 2014.

SPINAL,EPIDURAL/CAUDAL,PENILE NERVE BLOCK IN PEDIATRIC PATIENTS MODERATOR:Dr. JYOTI PATHANIA PRESENTED BY: Dr. SUCHIT KHANDUJA.

Types of Anaesthesia LOCAL ANAESTHESIA AND REGIONAL ANAESTHESIA PRPD/DN/2011.

Intrapartum Epidural Anaesthesia Max Brinsmead MB BS PhD May 2015.

TRANSFORAMINAL INJECTIONS OF STEROIDS AS A METHOD OF LOW BACK PAIN TREATMENT J. Les, J. Grzesiak, M. Sienkowska-Magon, A. Kwiecien - Department of Anaesthesia.

SPINAL AND EPIDURAL ANESTHESIA Mahmoud Ibrahim Abd El-fattah, md lecturer, anesthesiology departement, faculty of medicine, benha university.

Dr. Elham Tahaei NEURAXIAL ANALGESIA Neuraxial analgesia is the most reliable and effective method of reducing pain during labor. However, it is encumbered.

Prevention and diagnosis of infectious complications associated with neuraxial technique Pedro Tanaka

Regional Anaesthesia Techniques for Day- Surgery CSM 2011 Dr Michael Barrington Department of Anaesthesia St Vincent’s Hospital, Melbourne.

Complication of Hernia Repair Objectiv e To study the incidence of the complication of the indirect inguinal hernia repair To study the incidence of.

Giorgio Ivani, Italy Continuous Peripheral Nerve Blockade in Children Giorgio Ivani Giorgio Ivani Regina Margherita Children’s Hospital Turin Italy

In The Name of GOD M. A. Attari, MD. Associated Professor of Anesthesiology Medical University Of Isfahan

Inguinal Hernia of Premature Infants

Ultrasound in Obstetric Anaesthesia- Neuraxial Blockade Dr John Loughrey The Rotunda Hospital Dublin.

Dr. S. Parthasarathy MD., DA., DNB, MD (Acu), Dip. Diab. DCA, Dip. Software statistics PhD (physio) Mahatma Gandhi medical college and research institute.

Regional Anesthesia. Lecture Objectives.. Students at the end of the lecture will be able to:

Autonomic >> Sensory >> Motor  Neuraxial Spinal Epidural Caudal  Peripheral Nerve Block  IV Regional ( Bier block )

Birth Plan- Who? Obstetrician/Gynecologist  4 years of training in pregnancy, delivery and women health and infertility. Maternal-Fetal Specialist  High.

Anesthetic Risks รศ.นพ.เทพกร สาธิตการมณี หัวหน้าภาควิชาวิสัญญีวิทยา คณะแพทยศาสตร์ มหาวิทยาลัยขอนแก่น.

Epidural Anaesthesia.

Prof.Carole A. Devine RN.MSN.1 The Process of Birth.

Pain facts 5 Dr. S. Parthasarathy MD., DA., DNB, MD (Acu), Dip. Diab. DCA, Dip. Software statistics PhD (physio) Mahatma Gandhi medical college and research.

Use of lung function tests in paediatric asthma care A nationwide registry study Grete Moth, MHSc, Ph.D Danish Paediatric Asthma Centre Aarhus University.

Indications and Contraindications for Regional Anesthesia

Can the Epidural Catheter Be Removed with Warfarin? Department of Anesthesiology Rush University Medical Center Rush Medical College Chicago, IL Asokumar.

Transversus Abdominis Plane (TAP) Block in Paediatrics A novel approach to block of the anterior abdominal wall Cathy Roulson UHL Thursday 15 th May 2008.

Neuraxial Connector Surveillance Training

USE OF LOCAL ANAESTHETICS- CONTROVERSIES Prof Anil OHRI DEPTT OF ANAESTHESIA IGMC SHIMLA.

Regional Anesthesia In The Perioperative Setting Shelly Ferrell MD Assistant Professor Medical Director Acute Pain Service Department of Anesthesiology.

Local & regional anesthesia  Local anesthetic agent act by reducing membrane permeability to sodium  Act on small unmyelinated C fiber before large A.

Obesity in the Closed Claims Database

Copyright © 2014 American Medical Association. All rights reserved.

Imaging in Acute Mastoiditis

Birth Plan- Who? Obstetrician/Gynecologist

Anterior approaches of the Lumbar Plexus

Ambulatory General Surgery CarePath

EPIDURAL ANESTHESIA.

Facts and fiction of surgeons about PNB

Morbidity and regional anesthesia RCT vs. Big data

Dr David M Levy Consultant Obstetric Anaesthetist

RUKEWE A*, FATIREGUN A++, ALONGE TO**

From: Epidural Anesthesia Complicating Continuous 3-in-1 Lumbar Plexus Blockade Figure Legend: Figure 1. Radiograph (anterior view) taken after injection.

Introduction to Regional Anesthesia CA-1 Lecture

Is Non-operative Treatment of Inguinal Hernias a Reasonable Option?

Edin Begić, Nedim Begić, Amra Dobrača

Regional Anesthesia Approaches to Pain Management in Pediatric Palliative Care: A Review of Current Knowledge Jillian F. Rork, BA, Charles B. Berde,

Residual Paralysis Is More Common Than You Think

Improving Surgical Patient Safety

دانشگاه شهیدرجایی تهران

تعهدات مشتری در کنوانسیون بیع بین المللی

Session 20 Pain Medications.

Flap Failure (it happens to us all)

Suprapubic catheter insertion

MD., DA., DNB, MD (Acu), Dip. Diab. DCA, Dip. Software statistics-

“Regional Anesthesia”

Doses of trial medication in the liraglutide groups (A) and in the placebo groups (B). Doses of trial medication in the liraglutide groups (A) and in the.

CPSO Peer Assessment Form History & Physical (Items 2 - 8) Covered by PAU visit and you need to indicate you reviewed OR – you need to complete in Preop.

Presentation transcript:

UGRA in pedriatric anesthesia Markus F. Stevens Academic Medical Center Amsterdam

UGRA in pediatric anesthesia Practice Advisory of ESRA/ASRA Neuraxial anesthesia UGRA for caudal anesthesia? UGRA extremity blocks Inguinal hernia: caudal or TAP or IL/IH Umbilical hernia: caudal or TAP or rectus sheath Things I do NOT recommend Take home message

UGRA in pediatric anesthesia Practice Advisory of ESRA/ASRA Ivani G RAPM 2016

UGRA in pediatric anesthesia Practice Advisory of ESRA/ASRA PRA under GA/DS = acceptable safety (B2) Incidence complications low (0.66%) (B2) Incidence of paralysis is estimated 0-0.004% (B3) Use of epinephrine test dose questionable (C) Saline-LOR or Air-LOR ( < 1ml) (C) No evidence against PRA with risk of compartment (C) But low concentration, no additives ….. (C) Ivani G RAPM 2015

UGRA in pediatric anesthesia PRAN: retrospective study with > 50,000 RA Incidence of (transient) neurologic symptoms: 0.6/1000 (CI, 0.4–0.92) GA without NMB 2.4/1000 (CI, 1.6–3.6) GA with NMB 8.3/1000 (CI, 4.9–13.3) sedation 3.4/1000 (CI, 0.7–10.0) awake Taenzer AH RAPM 2014

UGRA in pediatric anesthesia PRAN study – use of localizing technique Polander DM AA 2012

UGRA in pediatric anesthesia Neuraxial anesthesia: spinal

UGRA in pediatric anesthesia Neuraxial anesthesia: epidural

UGRA in pediatric anesthesia Neuraxial anesthesia: epidural

UGRA in pediatric anesthesia Neuraxial anesthesia: epidural catheter

UGRA in pediatric anesthesia Neuraxial anesthesia Hermanns H BJA 2006

UGRA in pediatric anesthesia UGRA for caudal anesthesia?

UGRA in pediatric anesthesia UGRA for caudal anesthesia?

UGRA in pediatric anesthesia Extremity blocks

UGRA in pediatric anesthesia Extremity blocks

UGRA in pediatric anesthesia Inguinal hernia: caudal or TAP or IL/IH Baird D J Paediatr Surg 2013

UGRA in pediatric anesthesia Umbilical hernia: caudal or TAP or rectus sheath

UGRA in pediatric anesthesia Umbilical hernia: caudal or TAP or rectus sheath

UGRA in pediatric anesthesia Umbilical hernia: caudal or TAP or rectus sheath Dingeman RS JAMA Surg 2013

UGRA in pediatric anesthesia Things I do NOT recommend

UGRA in pediatric anesthesia Things I do NOT recommend Glover CD J Pediatr Orthop B 2015

UGRA in pediatric anesthesia Things I do NOT recommend

UGRA in pediatric anesthesia Take home messages: Performing RA under GA is safe Neuraxial US extremely helpful in baby’s Ultrasound not standard for caudal For Limb blocks UGRA is extremely helpful Caudal ≥ TAP ≥ pararectal/II/IH ≥ local infiltration Careful indication

Thank you for your attention