Continuous epidural block versus continuous psoas compartment block for postoperative analgesia after major hip or femoral surgery in children: a prospective comparative randomized study

Annales Françaises D'anesthèsie Et De Rèanimation
Christophe DadureX Capdevila

Abstract

Intravenous opioids and/or continuous epidural block (CEB) are used for postoperative analgesia after hip and/or femoral shaft surgery but adverse effects limit their use in children. A continuous psoas compartment block (CPCB), effective technique in adults can be an alternative. In this randomized comparative study, we wanted to evaluate CEB and CPCB in children after major hip surgery in terms of adverse events, pain relief and ropivacaine plasma concentrations. After ethical committee and parents' approval, 40 children scheduled for hip surgery were included and randomly allocated to receive CPCB or CEB. After general anaesthesia induction, 0.5 mL/kg of 0.375% ropivacaine were injected via the epidural or lumbar plexus catheter. After surgery, 0.1 ml/kg per hour (group CPCB) or 0.2 ml/kg per hour (group CEB) of 0.2% ropivacaine was infused for 48h. Post-operative pain was evaluated using VAS or CHIPPS scores values at h1, h6, h12, h18, h24, h36 and h48, as well as doses of first line (paracetamol 15 mg/kg/6h) or second line rescue analgesia (0.2mg/kg intravenous nalbuphine), if pain score remained high after 30 mm. niflumic acid was systematically used. Adverse events were noted as well as parents' satisfaction at 48h. Ropi...Continue Reading

References

Jul 1, 1994·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·C E WoodS G Neil
Oct 12, 2000·Acta Anaesthesiologica Scandinavica·T I Ala-KokkoS Alahuhta
Dec 5, 2000·British Journal of Anaesthesia·T G HansenR Bergesio
Jun 13, 2002·Acta Anaesthesiologica Scandinavica·L JylliG L Olsson
Aug 17, 2005·Paediatric Anaesthesia·Adrian T BösenbergLars E Larsson
Dec 22, 2005·Anesthesia and Analgesia·Jeffrey M RichmanChristopher L Wu

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Citations

Jan 1, 2013·Annales Françaises D'anesthèsie Et De Rèanimation·F Babre, Y Meymat
Apr 2, 2016·Journal of Clinical Monitoring and Computing·Yavuz GürkanMine Solak
Nov 5, 2011·Paediatric Anaesthesia·Christophe Dadure, Xavier Capdevila
Feb 9, 2012·Anaesthesia and Intensive Care·Phillip J CowlishawMichael J Barrington

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