Ultrasound‐guided selective supraclavicular nerve block for postoperative pain control in children receiving Hickman catheter or chemoport insertion: A randomized controlled trial

Abstract

BackgroundOptimal pain management after insertion of a central venous catheter in children remains unclear.AimThis study aimed to evaluate the effects of a selective supraclavicular nerve block on postoperative analgesia in pediatric patients undergoing hickman catheter or chemoport insertion.MethodsFifty patients aged 3–18 years scheduled for elective Hickman or chemoport insertion were randomized into two groups of 25 each: one group received an ultrasound‐guided selective supraclavicular nerve block with 0.1 mL/kg of 0.5% ropivacaine (SSCNB group), and the other group did not receive a nerve block (control group). The primary outcome was the postoperative Wong‐Baker Faces Pain Rating Scale score measured between 10 and 30 min after surgery. Secondary outcomes included pain scores at 1, 3, and 24 h after the surgery, block‐related complications, length of stay in the postanesthesia care unit, postoperative analgesic consumption, and time to first analgesic use 24 h after surgery.ResultsThe worst pain score within 30 min in the recovery room was significantly lower in the SSCNB group compared to the control group (6 [5–7] vs. 3 [2–4]; median difference, −3; 95% CI, −4 to −1; p < .001). Pain scores at 1, 3, and 24 h after surgery were also significantly lower in the SSCNB group. The need for both opioid and non‐opioid analgesics in the postoperative period was significantly lower in the SSCNB group (36.0% vs. 0%; p = .002 and 44.0% vs. 16.0%; mean difference, −28%; 95% CI, −56 to 0.19; p = .033, respectively), while other secondary outcomes were not significantly different between the two groups.ConclusionsUltrasound‐guided SSCNB is an effective method for managing postoperative pain in children undergoing Hickman catheter or chemoport insertion, reducing the need for analgesics within 24 h after surgery.

Determining postoperative analgesic efficacy of a regional block for pediatric patients

“…To the Editor, With great interest, we read the recent article by Park et al, 1 in which an ultrasound-guided selective supraclavicular nerve block before surgical incision was demonstrated as an effective postoperative analgesia technique for pediatric patients who underwent Hickman catheter or chemoport insertion. We sincerely congratulate the authors for their work that attempted to explore a new postoperative analgesia method for pediatric patients.…”