Anesthesia and pain management are important aspects of care for children undergoing surgical procedures. Regional anesthetics play an integral role in pain management and can supplement or even replace traditional general anesthesia. These techniques provide a focused anesthetic to a specific part of your child's body, without requiring a full general anesthetic. They have been shown to improve outcomes in children who have undergone surgery, including fewer side effects, faster recovery, and less time in the hospital compared with general anesthesia. They can also limit or eliminate the need for pain medications such as opioid drugs and other narcotics.
The skilled doctors from the Regional Anesthesia Program at Boston Children's Hospital offer a variety of anesthetic and pain management options to eligible patients, including:
- single-shot regional anesthetics, which can last anywhere from 12 to 48 hours
- catheter-based regional anesthetics, in which a hollow tube called a catheter is left in place and allowed to infuse the affected area with local anesthetics so that pain relief can last as long as needed following surgery. Some patients are eligible to be discharged with a catheter for continued pain control while at home. This is done through the BHAPPY Program.
Both single shots and catheters can be placed in various locations on your child's body, including the spine, arms, legs, chest, abdomen, and back.
Regional anesthetics can be used in several ways. They can supplement a general anesthetic and reduce the use of higher doses of gas and intravenous medications. Regional anesthetics can also be used instead of general anesthesia to avoid intubation or control the erratic changes in blood flow associated with surgery. This can help minimize complications, especially in children with brain, heart, or lung disease, where the use of a standard anesthetic may be more dangerous. Finally, regional anesthetics can be used to improve the postoperative recovery process. These techniques usually provide superior pain control because they don't have the side effects of traditional pain medications, such as nausea, vomiting, altered breathing, sedation, and delayed recovery of the intestines, which can delay the ability to eat.
While every child is different, regional anesthesia may be an option if your child is undergoing an operation on their hip, knee, hand, shoulder, chest, or abdomen. It can also be used in children being treated for lung pathologies, gastric surgery, vascular anomalies, cardiac surgery, craniofacial anomalies (such as cleft lip and palate), or esophageal atresia.
Our approach to regional anesthesia
The Regional Anesthesia Program is part of Boston Children's Department of Anesthesiology, Critical Care and Pain Medicine. We work closely with the division and all of the surgical specialties to provide our young patients with the safest and most effective anesthesia and pain control available. As the largest program of our kind in the U.S., we perform about 3,000 nerve blocks a year, giving us an unparalleled depth of experience in this area.