Local Hematoma Block as Postoperative Analgesia in Pediatric Supracondylar Humerus Fractures

Astacio, Eric; Echegaray, Gabriel; Rivera, Lenny; Otero-Delgado, Jorge M.; Olivella, Gerardo; Ramírez, Norman; Ramos-Alconini, Nestor; Foy, Christian A.

doi:10.1016/j.jhsg.2020.02.001

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…The results showed that hematoma block could relieve pain and reduce the dose of postoperative morphine, codeine and other analgesics. In a recent study, Astacio et al [22] performed a 0.25% bupivacaine local hematoma block in children with humeral supracondylar fracture after CRPP. Compared with the control group, postoperative use of morphine doses and pain score were not signi cantly different between groups, therefore the author suggested that hematoma block is not an effective method to relieve postoperative pain of supracondylar humeral fracture [22] .…”

Section: Discussionmentioning

confidence: 99%

Intra-Articular Bupivacaine Injection is An Ideal Method for Postoperative Pain Control in Children with Supracondylar Humeral Fracture

Wang¹,

Zhao²,

Wang³

et al. 2021

Preprint

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Objective: Supracondylar humeral fracture is the most common fracture in children. Currently there are a large number of studies on supracondylar humeral fractures addressing the epidemiology of supracondylar fractures, injury mechanisms, treatments and complications, however there are few studies on how to control the pain in children after fractures and operation. Therefore, we retrospectively analyzed the effectiveness of an intra-articular injection of 0.25% bupivacaine on pain control after CRPP of supracondylar humeral fractures in children. To our knowledge, this is the largest study on the use of an intra-articular injection for pain control after surgery for supracondylar humeral fractures.Methods: This clinical trial was designed to evaluate the efficacy of intra-articular injection of 0.25% bupivacaine as a postoperative pain control in children with supracondylar humeral fractures who underwent closed reduction and percutaneous pinning (CRPP).Subjects (n = 120) were randomized to treatment with 0.25% bupivacaine (treatment group) (n = 60) or no injection (control group) (n =71). After surgery, all patients were prescribed Ibuprofen for analgesia. The Ibuprofen doses and the times of administration were recorded. The Faces Pain Scale-Revised (FPS-R) scores were blindly recorded during postoperative day 1.Results: The results suggested that the use of intra-articular injection of 0.25% bupivacaine improved pain control and decreased the need for Ibuprofen on postoperative day 1. FPS-R scores were also significantly lower in the treatment group as compared with those of the control group. No intra-articular injection-associated complications were reported. Conclusion: Therefore, the intra-articular injection of bupivacaine significantly improves postoperative pain control following CRPP of supracondylar humeral fractures in children.

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Section: Discussionmentioning

confidence: 99%

Intra-Articular Bupivacaine Injection is An Ideal Method for Postoperative Pain Control in Children with Supracondylar Humeral Fracture

Wang¹,

Zhao²,

Wang³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…They also noted HB treatment's effect on pain severity as significantly better than PSA's effect. Alternatively, in a prospective cohort study, Astacio et al evaluated the efficacy of local 0.25% bupivacaine HB as postoperative pain control in pediatric patients (average age = 6 years, range 4-11) with supracondylar humeral fracture who underwent closed reduction pin fixation 41. This study's results did not favor the use of HB to improve pain control or decreased opioid use on postoperative day 1.…”

mentioning

confidence: 99%

Regional and Local Anesthesia in Pediatric Orthopaedic Surgery

Stinson¹,

Ghattas²,

Crepeau³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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Pediatric orthopaedic surgical procedures require a thoughtful multimodal approach to perioperative pain management that maximizes both patient comfort and safety. Local infiltrative anesthesia (LIA) provides limited anatomic coverage over a relatively short length of time. In comparison, regional anesthesia can provide increased anatomic coverage over a longer duration by applying anesthetic medication directly around a targeted peripheral nerve or nerves. Peripheral nerve blocks (PNB) are commonly used in pediatric and adolescent sports medicine procedures, especially for anterior cruciate ligament reconstructions (ACLR). Yet there remains a wide variation in how PNBs are performed with limited evidence in support of their overall benefits in children relative to potential complications, such as prolonged sensory or motor nerve paralysis. Even less is known about their use and indications for a variety of non-sports pediatric orthopaedic procedures. This article provides a review on the uses and indications of both local and regional anesthesia in pediatric orthopaedics with a discussion on the available evidence in the literature on safety and efficacy. Key Concepts• The use of PNBs in the pediatric population has been increasing, especially for ACLR procedures.• PNBs can result in improved immediate postoperative analgesia, but they have not been shown to significantly decrease overall postoperative opioid consumption.• PNBs have a higher risk profile than LIA, and the incidence and long-term significance of these risks has not been sufficiently studied.• The use of ultrasonography improves the safety and effectiveness of PNBs.

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Local Hematoma Block as Postoperative Analgesia in Pediatric Supracondylar Humerus Fractures

Cited by 2 publications

References 30 publications

Intra-Articular Bupivacaine Injection is An Ideal Method for Postoperative Pain Control in Children with Supracondylar Humeral Fracture

Intra-Articular Bupivacaine Injection is An Ideal Method for Postoperative Pain Control in Children with Supracondylar Humeral Fracture

Regional and Local Anesthesia in Pediatric Orthopaedic Surgery

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