RESUMO
STUDY OBJECTIVE: To compare the femoral nerve block with the fascia iliaca block for postoperative analgesia in adolescents undergoing reconstructive knee surgery. DESIGN: Randomized, single-blinded study. SETTING: Full-service pediatric medical center. PATIENTS: 23 ASA physical status I and II patients, aged 8 to 16 years, undergoing anterior cruciate ligament (ACL) repair. INTERVENTIONS: Patients received either fascia iliaca or femoral nerve block prior to reconstructive surgery. MEASUREMENTS: Pain scores by visual analog scale (VAS; 0-10) and morphine use were routinely recorded through to discharge from the hospital. Pain scores were assessed on days 1 and 2 at home post-discharge. MAIN RESULTS: There was no difference between the femoral nerve block and the fascia iliaca nerve block in VAS pain scores or postoperative morphine consumption. CONCLUSION: Either the femoral nerve block or the fascia iliaca block, followed by patient-controlled analgesia with morphine, provides efficacious analgesia for adolescents undergoing ACL reconstruction.
Assuntos
Anestésicos Locais/uso terapêutico , Ligamento Cruzado Anterior/cirurgia , Bloqueio Nervoso/métodos , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Analgésicos Opioides/uso terapêutico , Anestésicos Locais/administração & dosagem , Lesões do Ligamento Cruzado Anterior , Criança , Fáscia , Nervo Femoral , Humanos , Traumatismos do Joelho/cirurgia , Morfina/uso terapêutico , Medição da Dor , Dor Pós-Operatória , Método Simples-CegoAssuntos
Antígenos Glicosídicos Associados a Tumores/imunologia , Espasmo Brônquico/etiologia , Enterocolite Necrosante/cirurgia , Transfusão de Eritrócitos/efeitos adversos , Complicações Intraoperatórias/imunologia , Doença Aguda , Albuterol/uso terapêutico , Antígenos Glicosídicos Associados a Tumores/sangue , Espasmo Brônquico/sangue , Espasmo Brônquico/tratamento farmacológico , Broncodilatadores/uso terapêutico , Humanos , Recém-Nascido , Complicações Intraoperatórias/sangue , Masculino , Respiração ArtificialRESUMO
Diagnosis and treatment of complex regional pain syndrome in children is one of the most challenging clinical pain problems encountered in the chronic pain setting. Despite the intense and debilitating nature of the pain, referral to appropriate specialists often comes too late, thereby prolonging an already arduous (and controversial) course of treatment and risking long-term disability. On the contrary, full recovery can be expected with early diagnosis and prompt treatment. The following case study describes a novel and successful use of intrathecal catheter administration of ropivacaine in a child with early, rapidly progressing, and debilitating complex regional pain syndrome.
