Blocks for pain management in children undergoing ambulatory surgery

Purpose of review Data from the USA show that the number of paediatric outpatient procedures has increased by almost 50% during the time period 1996-2006. Despite this increasing trend with regards to ambulatory surgery in children postoperative analgesia is still often suboptimal. The aim of this review is to give an overview of different regional anaesthesia techniques that successfully can be used in paediatric ambulatory surgery. Recent findings Regional anaesthesia, especially the increasing use of ultrasound-guided peripheral nerve blocking techniques, provide maybe the best way of achieving high-quality early postoperative pain relief and the use of continuous peripheral catheters appear very promising in order to extend analgesia after the return home. If used appropriately the use of regional anaesthesia may in some instances even make it possible to bypass the recovery room. Summary Current evidence strongly supports the use of various regional anaesthetic techniques in paediatric outpatient surgery. However, further studies are needed to identify the incidence and severity of pain following different common ambulatory surgical procedures in children as well as comparative prospective randomized trials comparing different regional techniques as well as comparing regional anaesthesia to the best current combination of oral analgesics.