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Article Details

Case Series
Volume 3, Issue 1 (February Issue)

Pain Management for Pediatric Hip Surgery with Lumbar Erector Spinae Plane Block: A Case Series

Sampaguita Tafoya1*, Sundeep Tumber1, Holly Leshikar2 and Christopher Nguyen1

1Department of Anesthesia, Shriners Children’s Northern California, Sacramento, California, USA

2Department of Orthopedic Surgery, Shriners Children’s Northern California, Sacramento and Department of Orthopedic Surgery, UC Davis, Sacramento, California, USA

*Corresponding author: Sampaguita Tafoya, Department of Anesthesia, Shriners Children’s Northern California, Sacramento, California, USA.

Received: May 16, 2023; Accepted: May 28, 2023; Published: July 05, 2023

Citation: Tafoya S, Tumber S, Leshikar H, Nguyen C. Pain Management for Pediatric Hip Surgery with Lumbar Erector Spinae Plane Block: A Case Series. Case Rep Orthop Surg J. 2023; 2(3): 119.

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Abstract

Background: Multimodal strategies are frequently used to manage postoperative pain after pediatric hip surgery, including spinal and epidural techniques. The lumbar erector spinae plane (ESP) block is a novel, less invasive regional anesthesia option that may offer improved postoperative analgesia in this population.

Methods: This retrospective case series included 11 pediatric patients who underwent Pemberton osteotomy surgery and received lumbar ESP block(s). Intraoperative block medications, anesthetic techniques, surgical characteristics, postoperative observational pain scores, opioid consumption, length of stay, and side effects were recorded.

Results: The mean intraoperative total opioid consumption consisted of fentanyl 2.1 ± 1.6 mcg/kg and morphine 0.05 ± 0.06 mg/kg. The mean postoperative pain scores (scale 1-10) were 0.4 ± 0.5; maximum pain scores were 2.0 ± 2.4. The mean length of stay was 30.2 ± 10.3 hrs. Postoperative nausea was observed in 36% of patients; none had respiratory depression or urinary retention. The ESP block medications included ropivacaine or bupivacaine with one or more duration-prolonging adjuvants.

Conclusions: Lumbar ESP blocks provide effective analgesia for the management of pediatric pain after hip surgery, and potentially mitigate some of the risks associated with spinal and epidural techniques.

Keywords: Hip; Pelvic osteotomy; Nerve block; Erector spinae plane block; Pediatric