Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Walker Benjamin J, Long Justin B, Sathyamoorthy Madhankumar, Birstler Jennifer, Wolf Christine, Bosenberg Adrian T, Flack Sean H, Krane Elliot J, Sethna Navil F, Suresh Santhanam, Taenzer Andreas H, Polaner David M, Martin Lynn, Anderson Corrie, Sunder Rani, Adams Trevor, Martin Lizabeth, Pankovich Martha, Sawardekar Amod, Birmingham Patrick, Marcelino Ryan, Ramarmurthi R J, Szmuk Peter, Ungar Galit Kastner, Lozano Sara, Boretsky Karen, Jain Ranu, Matuszczak Maria, Petersen Timothy R, Dillow Jennifer, Power Robert, Nguyen Kim, Lee Benjamin H, Chan Lisa, Pineda Jorge, Hutchins Jacob, Mendoza Kimberly, Spisak Kristen, Shah Aali, DelPizzo Kathryn, Dong Naomi, Yalamanchili Vidya, Venable Claudia, Williams Cassandra Armstead, Chaudahari Reena, Ohkawa Susumu, Usljebrka Helga, Bhalla Tarun, Vanzillotta Pedro Paulo, Apiliogullari Seza, Franklin Andrew D, Ando Akiko, Pestieau Sophie R, Wright Caroline, Rosenbloom Julia, Anderson Tony, Pediatric Regional Anesthesia Network Investigators
Аннотация
METHODS: This is a prospective, observational study of routine clinical practice. Data were collected on every regional block placed by an anesthesiologist at participating institutions and were uploaded to a secure database. The data were audited at multiple points for accuracy.
RESULTS: There were no permanent neurologic deficits reported (95% CI, 0 to 0.4:10,000). The risk of transient neurologic deficit was 2.4:10,000 (95% CI, 1.6 to 3.6:10,000) and was not different between peripheral and neuraxial blocks. The risk of severe local anesthetic systemic toxicity was 0.76:10,000 (95% CI, 0.3 to 1.6:10,000); the majority of cases occurred in infants. There was one epidural abscess reported (0.76:10,000, 95% CI, 0 to 4.8:10,000). The incidence of cutaneous infections was 0.5% (53:10,000, 95% CI, 43 to 64:10,000). There were no hematomas associated with neuraxial catheters (95% CI, 0 to 3.5:10,000), but one epidural hematoma occurred with a paravertebral catheter. No additional risk was observed with placing blocks under general anesthesia. The most common adverse events were benign catheter-related failures (4%).
CONCLUSIONS: The data from this study demonstrate a level of safety in pediatric regional anesthesia that is comparable to adult practice and confirms the safety of placing blocks under general anesthesia in children.