Abstract
BackgroundUltrasound-guided supra-clavicular nerve block (SCNB) has regained interest in adults but remains underutilized in pediatrics. This case series aims to evaluate the efficacy and safety of ultrasound-guided SCNB in children undergoing upper-extremity surgery. MethodsProspective observational case series, the inclusion criteria were children over one year old who were scheduled for elective upper-extremity surgery. After induction of general anesthesia, an ultrasound-guided SCNB was performed. A dose of 0.2–0.5 ml/kg of bupivacaine 0.25 % or ropivacaine 0.2 % was administered all around the brachial plexus. In case of postoperative pain, 15 mg kg-1 of paracetamol + 10 mg kg-1 of ibuprofen were administered. The primary outcome measure was the success and safety of the block. Secondary outcomes were time to first analgesia administration and duration of motor blockade. ResultsThirty-three patients were included. Median age and weight were 6 [2.75,9.75] years and 24 [16,35] kg, respectively with a sex ratio of 3.1. Bupivacaine 0.25 % was used in the majority of cases (N = 24). The overall duration to complete block performance was 170 [120,300] seconds. A single attempt was sufficient for the majority of children, with a block success rate of 100 %. No incidents were reported during block performance. Postoperatively, time to the first analgesic request was 10 [8,12.5] hours. Twenty-five patients developed a motor block, with a duration of 4 [0.5,5] hours. Bupivacaine 0.25 % was associated with higher incidence of motor blockade (p = 0.002). ConclusionsUltrasound-guided SCNB appears to be an effective and safe technique in children. Further studies using lower doses of bupivacaine could help reduce the incidence of motor block.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.