[Regional anesthesia in children].

Regional anaesthesia is today a well established method for providing pain control in children. We must consider two kinds of problems: problems unique to paediatric population and problems that are the same in adults. A good knowledge of paediatric anatomy is mandatory for regional anaesthesia. Physiology in newborn and infants differ from older children and adults; metabolism and clearance of drugs, local anaesthetic included, are reduced so that we have a narrow therapeutic window and an increased toxicity. Moreover, the risk of inadvertent intravascular injection exists and can be minimized only with adequate monitoring along the performance of block. The availability of new local anaesthetics enantiomers such as ropivacain and levobupivacain, can add safety to regional anaesthesia and the addition of adjuvants like clonidine and ketamine contribute to the reduction of risks connected with toxicity. Performance of a block during anaesthesia is safer than when performed in an awake child.