Multimodal Management of Postoperative Pain in Pediatrics Using Ultrasound-Guided Regional Blocks
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Abstract
Inadequately managed pediatric postoperative pain causes neuroplastic changes in the developing nervous system, leading to central sensitization and increasing the risk of chronic postoperative pain. To evaluate the analgesic efficacy, reduction in opioid use, and safety profile of multimodal pain management combined with ultrasound-guided regional blocks in pediatrics. A structured systematic review following the PRISMA statement (2020–2026) was conducted in databases such as PubMed, SciELO, LILACS, MEDES, Trip Database, and the scientific journal *Ciencia y Método*, selecting 26 studies of high methodological quality. Ultrasound-guided blocks such as the caudal block, TAP, and ESPB reduced rescue opioid use by 40% to 60%, achieved low scores on the FLACC scale, and minimized systemic toxicity thanks to real-time visual monitoring of the local anesthetic. Ultrasonography surpasses traditional anatomical techniques by offering greater precision and safety; however, it requires a specialized learning curve and continuous innovation among healthcare teams. Ultrasound-guided multimodal management represents an indispensable paradigm that attenuates the neuroendocrine response to surgical stress, prevents the chronicity of pain, and optimizes pediatric recovery.
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