Peripheral Nerve Blockade and Neonatal Limb Ischemia Our Experience and Literature Review

• Published in: Clinical and applied thrombosis/hemostasis Vol. 20; no. 1; pp. 55 - 60
• Main Authors: Carolis, Maria Pia De, Bersani, Iliana, Piersigilli, Fiammetta, Rubortone, Serena Antonia, Occhipinti, Federica, Lacerenza, Serafina, Romagnoli, Costantino
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2014
• Subjects: Arm - blood supply; Humans; Infant, Newborn; Ischemia - drug therapy; Ischemia - etiology; Ischemia - therapy; Leg - blood supply; Nerve Block - methods; Peripheral Nerves; Thrombosis - complications; neonatal thrombosis; anticoagulants; thrombolytics
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/1076029612458968

Considering the high frequency of bleeding complications following fibrinolytic treatment in neonates, peripheral nerve blockade (PNB) has been proposed alone or in association with lower doses of tissue plasminogen activator, as a possible new therapeutic approach in the management of neonatal limb ischemia (LI) secondary to vasospasm and/or thrombosis. The present article provides a review of the current knowledge about the topic, in order to evaluate the efficacy and safety of this therapeutic approach. According to the few case reports documented in literature and to our experience, PNB could be considered as valid procedure for the treatment of LI, especially during neonatal period, when the risk of serious bleeding associated with fibrinolytic or anticoagulant therapy is higher. Peripheral nerve blockade resulted in a safe and effective procedure for the treatment of neonatal vascular spasm and thrombosis.