Methods of regional analgesia in abdominal surgery in pediatrics

Introduction . Adequacy of perioperative analgesia is one of the main issues of surgical care. Anatomo-physiological and psychological characteristics of childhood necessitate more thorough approach to this problem in pediatric anesthesiology, since ensuring optimal analgesia provides prevention of somatic perioperative complications and influences further physiological neuropsychiatric development of a child. The objective was to compare regional techniques of perioperative analgesia during abdominal interventions in children and to discuss the conditionsof their application and effectiveness. Materials and Methods . A literature search was conducted using PubMed, Medline, Embase, and Google Scholar databases. Both English – and Russian-language publications indexed in Scopus and RSCI were included in the search. Results . Among methods of regional anesthesia, neuroaxial blockade options, which have both high proven efficacy and several disadvantages and complications, remain the most popular techniques. Currently, the alternative methods are available, presented as interfascial blockades with anefficacy comparable to neuroaxial techniques and a wide safety profile. Among these techniques, we can distinguish rectus sheath block, transversus abdominis plane block, erector spinae plane block and other methods. Conclusion . Despite advances in pain management, inadequate postoperative analgesia in pediatric practice remains a serious problem. Therefore, it is important to optimize the treatment of postoperative pain in children by applying multimodal analgesia using modern regional blockades.