Perioperative pain management of a complex orthopedic surgical procedure with double continuous nerve blocks in a burned child.

UNLABELLED The use of catheters for continuous nerve blocks has been established in children, although in most series only one catheter was used. We report a case of a 3-yr-old child who underwent a toe-to-finger transfer managed with 2 regional catheters: axillary and sciatic. A pain score of 0 was noted during the entire study period. The total dose of bupivacaine was limited to an acceptable range, and the child recovered completely. This report adds to growing evidence in favor of the safety and efficacy of continuous peripheral nerve blocks in pediatric patients. IMPLICATIONS Double continuous nerve blocks allow optimal analgesia in burned children after complex orthopedic surgery without major adverse events. Plasma concentrations of bupivacaine remained small during the study period.

[1]  T. Beushausen,et al.  Anesthesia and pain management in pediatric burn patients , 1997, Pediatric Surgery International.

[2]  J. Latarjet [The pain from burns]. , 2002, Pathologie-biologie.

[3]  D. Sciard,et al.  Continuous posterior lumbar plexus block for acute postoperative pain control in young children. , 2001, Anesthesiology.

[4]  B. Bruguerolle,et al.  Continuous Fascia Iliaca Compartment Block in Children: A Prospective Evaluation of Plasma Bupivacaine Concentrations, Pain Scores, and Side Effects , 2001, Anesthesia and analgesia.

[5]  A. Wiebalck,et al.  Pain Management in Children: Assessment and Documentation in Burn Units , 2001, European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie.

[6]  G. Gallagher,et al.  Treatment of Pain in Severe Burns , 2000, American journal of clinical dermatology.

[7]  W. Büttner,et al.  Analysis of behavioural and physiological parameters for the assessment of postoperative analgesic demand in newborns, infants and young children: a comprehensive report on seven consecutive studies , 2000, Paediatric anaesthesia.

[8]  Benzer,et al.  Free and total bupivacaine plasma concentrations after continuous epidural anaesthesia in infants and children , 1998, Paediatric anaesthesia.

[9]  T. Horlocker Peripheral nerve blocks--regional anesthesia for the new millennium. , 1998, Regional anesthesia and pain medicine.

[10]  F. Singelyn,et al.  Continuous Popliteal Sciatic Nerve Block: An Original Technique to Provide Postoperative Analgesia After Foot Surgery , 1997, Anesthesia and analgesia.

[11]  B. Dalens,et al.  Epidemiology and Morbidity of Regional Anesthesia in Children: A One-Year Prospective Survey of the French-Language Society of Pediatric Anesthesiologists , 1996, Anesthesia and analgesia.

[12]  S. Vilkki,et al.  Anaesthesia for microvascular surgery in children , 1995 .

[13]  J. Latarjet,et al.  La douleur du brûlé , 1995 .

[14]  P. Neuvonen,et al.  Anaesthesia for microvascular surgery in children. A combination of general anaesthesia and axillary plexus block. , 1995, Acta anaesthesiologica Scandinavica.

[15]  Tobias Jd Continuous femoral nerve block to provide analgesia following femur fracture in a paediatric ICU population. , 1994 .

[16]  J. Tobias Continuous femoral nerve block to provide analgesia following femur fracture in a paediatric ICU population. , 1994, Anaesthesia and intensive care.

[17]  C. Johnson Continuous Femoral Nerve Blockade for Analgesia in Children with Femoral Fractures , 1994, Anaesthesia and intensive care.

[18]  C. Meistelman,et al.  Continuous epidural infusion of bupivacaine for postoperative pain relief in children. , 1987, Anesthesiology.

[19]  C. Meistelman,et al.  Continuous Epidural Infusion of Bupivacaine for Postoperative Pain Relief in Children , 1986 .