Hadzic's Regional Anesthesia > Part VII. Regional Anesthesia for Pediatric Surgery > General Concepts

Introduction

"Dating back to ancient Egypt of 2500 BC, regional anesthesia was emphasized for circumcision. Traditional Chinese medicine has touted the use of needles and acupuncture for pain management for centuries. August Bier reported in 1899 the first study on regional anesthesia in children. This was followed by a report by Bainbridge on the use of spinal anesthesia in children.¹ The use of caudal analgesia in children was described in the urology literature in the early 1930s.² In the past two decades, numerous studies have demonstrated the need for analgesia in newborn children and infants.³ This has resulted in significant changes and advances in clinical anesthesia care for infants, children, and adolescents. In particular, the decrease in stress has resulted in better outcomes in infants and children. Infants exposed to significant pain in the neonatal period may experience biobehavioral changes with advancing age.⁴ This and other related research have led the medical community to improve analgesia in infants. Although research in regional anesthesia in adults continues to be performed and is written about prolifically in literature, there seems to be a relative lack of publications in regional anesthesia in children. Most work in regional anesthesia has been carried out by a few researchers with a firm commitment to the use of regional techniques in children. Although the usual dictum that children are just small adults may apply to regional analgesia in the adolescent population, it is much less applicable..."