Supine interface pressure in children.

The effectiveness of using 2-inch and 4-inch convoluted foam overlays to protect children from developing pressure sores was investigated in 13 healthy children ranging in age from ten weeks to 13.5 years. Interface pressures were measured under the occipital, sacral, and scapular areas of children as they lay on a standard mattress, then on 2-inch and 4-inch foam overlays. The differences in pressures between the occiput and scapula, occiput and sacrum, and scapula and sacrum were significant (p less than .001), with the highest pressures recorded under the occipital area. Occipital pressures decreased from 45.7mmHg on the standard mattress to 22.3mmHg on the 4-inch overlay in ages 0 to 2, 54.3mmHg to 30.5mmHg in ages 2 to 10, and 78.0mmHg to 42.4mmHg in ages 10 to 14. Sacral pressures were highest in older and larger children, increasing from 17mm Hg in ages 0 to 2 to 34mmHg in ages 10 to 14, and when body surface area was greater than 1m2. These results indicate that the site of greatest pressure changes with increasing age from the occipital area to the sacral area. Therefore, different pressure relief considerations are necessary in treating pediatric patients than in managing pressure under adults.

Obturator nerve block for painful hip in adult cerebral palsy.

Nearly 25% of patients with severe spastic cerebral palsy (CP) develop hip dislocations/subluxations which may become painful. Three patients with spastic CP and painful hip dislocations/subluxations, who were poor surgical candidates and were unresponsive to conservative medical management, underwent obturator nerve block which resulted in temporary relief of pain and improved their activities of daily living. There were no known complications from this procedure.