Brachial plexus anesthesia in pediatric patients.

Abstract

Between 1980 and 1988 at our institution, brachial plexus anesthesia (BPA) was used in 109 pediatric patients who underwent 142 surgical procedures on an upper extremity, including 134 axillary blocks. Most patients older than 6 years of age had their blocks and surgical procedures with moderate sedation. The success rate was high--92.4% of axillary blocks and 100% of other blocks were adequate for surgical intervention in patients who required only intravenous sedation. The postoperative course in the BPA group was compared with that in 109 age-matched control subjects who underwent 188 procedures on an upper extremity during general anesthesia (GA). Admission to the recovery room after anesthesia occurred less frequently in the BPA group than in the GA group (27.5% versus 91.0%; P less than 0.01). Furthermore, nausea and vomiting were less frequent in the BPA group than in the GA group (P less than 0.01). Outpatients in the BPA group were less likely to require narcotic analgesics before dismissal than were those in the GA group (12% versus 31%; P less than 0.05). Admission of outpatients was infrequent in both groups (2% for BPA and 9% for GA). No significant difference was noted in 24-hour postoperative narcotic requirements between the BPA and GA groups.