Background and Aims Pediatric population is a challenge in performing and evaluating regional anesthesia. Current trendprefers regional blocks over general anesthesia, and peripheral regional blocks over central ones. Comparison of intra- and postoperative analgesia with perioperative popliteal nerve block under sedation versus general anesthesia in pediatric patients undergoing ankle surgery
Methods 108 patients (period of 2 years), 7 y-17 y old for ankle surgery. ASA I 1–2. R group: perioperative popliteal nerve block + sedation (n=35, 32.4%). G group: general anesthesia: TIVA+opioid (n=73, 67.6%). R group: Propofol V=3mg/kg/h+ regional anesthesia. G group: general anesthesia: propofol 4mg/kg i.v. bolus dose+perfusion 12mg/kg/h+fentanyl 2mcg/kg+laryngeal mask. G group intraoperative evaluation: hemodynamics, respirations. R group intraoperative evaluation: hemodynamics, respirations, Visual Analogue Scale (VAS) self assessment, complaints. Postoperative evaluation for both groups (for 48h): VAS, self assessment, hemodynamics, respirations, additional analgesia.
Results R group: No complications.. 2 patients (5.71%) received single NSAID (VAS 4p) after surgery. 94.28%- no additional analgesia.
G group: No complications. Higher doses intraoperative sedatives and opioids. Multimodal postoperative analgesia
Conclusions Popliteal nerve block provides effective analgesia; reduces the need for general anesthesia, opioids, additional medication; improves patient‘s rehabilitation, recovery and comfort; lessens or even eliminates the need of opioid analgesia. It is a safe, effective and reliable method for treating perioperative pain in pediatric patients.
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