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#36410 Opioid-free anaesthesia: the value of peripheral and central blocks in subumbilical and urogenital surgery in children
  1. Maha Ben Mansour1,
  2. Imen Trimech1,
  3. Sabrine Ben Youssef2,3,
  4. Fares Ben Salem1,
  5. Sarra Sammari1,
  6. Faouzi Ben Salem1,
  7. Sawsen Chakroun4 and
  8. Mourad Gahbiche1
  1. 1Anesthésie Réanimation, CHU Fattouma Bourguiba Monastir, monastir, Tunisia
  2. 2Chirurgie pédiatrique, CHU Fattouma Bourguiba Monastir, monastir, Tunisia
  3. 3Chirurgie pédiatrique, CHU Fattouma Bourguiba Monastir, monastir, Tunisia
  4. 4Anesthésie Réanimation, CHU Fattouma Bourguiba Monastir, Monastir, Tunisia


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Background and Aims The aim of anaesthesia is patient and surgeon comfort, avoiding intraoperative memory and pain. OFA is a multimodal anaesthesia technique that provides adequate analgesia while avoiding the side effects of morphine. .In this context, a study was carried out using an OFA protocol in sub- umbilical and urogenital surgery in children using loco-regional anaesthesia as an alternative to morphine.

Methods Prospective study conducted in the pediatric surgery. This study included children proposed for a surgical procedure scheduled under general anesthesia. Perioperative analgesia by performing peripheral blocks and central blocks according to the type of surgery.

Results 82 children were included in the study, 90% of them were male, 42.5% of the children had a weight between 11kg and 15kg. 95% were classified as ASAI. The most common surgery was inguinal hernia in 17.5% followed by testicular ectopy. More than 2/3 of the children underwent outpatient procedures. Intravenous induction was done with propofol in 97.5% of cases at 3-5mg/kg. Laryngeal mask insertion was the upper airway management technique in 57.5%. Pudendal block was the most used technique in 27.5%. Maintenance was done for all children with 2-3% Sevoflurane. 82.5% of the children did not show a change in heart rate or major haemodynamic changes. Only 20% required anticipatory analgesia with Paracetamol. 42.5% of children had mild discomfort in the immediate postoperative period. No child presented with a complication of loco- regional anaesthesia.

Conclusions OFA in paediatric anesthesia allowing adequate analgesia while avoiding the side effects of opioids; respiratory distress which is increased in children, ileus postoperatively.

  • opioid free anesthesia
  • children
  • surgery
  • central block

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