ESRA Academy. Lee C. Sep 8, 2016; 138367; 0205 Topic: Paediatric Population
Dr. Chang Chuan, Melvin Lee
Dr. Chang Chuan, Melvin Lee

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Background and Aims:

In total knee replacement (TKR), peripheral nerve blockade (PNB) has been widely studied and is recommended for intra-operative and early post-operative analgesia. However, this is less certain for less extensive knee surgeries such as arthroscopy and meniscus/cruciate ligament repairs. Moreover, concerns over chondrotoxicity preclude the use of intra-articular LA injection in the latter. PNB performed in children under GA is not without risks and needs to be weighed against its benefits. We aim to explore the patients’ (or parent’s) pre-operative expectations, post-operative experience, pain relief, and block-related complications.


Post-operative patients (aged 1-21 years) who underwent elective, non-TKR knee surgeries from November 2012 to October 2014 were identified from the audit database of a tertiary children’s hospital. A cross-sectional survey of patients and their parents was conducted via phone interviews in August 2015 using a prospectively-designed questionnaire.


Out of 157 patients identified, 101(64.3%) patients responded. Generally, patients in the PNB group underwent more invasive surgeries such as anterior cruciate ligament reconstruction. Out of the 66 who received a PNB, 62 (93.9%) felt that this helped with managing immediate post-surgical pain. Although 21 (31.8%) encountered difficulty caring for an insensate limb, 75.0% patients felt inclined to choose it again. No major complications were reported in the PNB group.


Despite the risks of PNB and potential problems when caring for an insensate limb, a significant proportion of patients found PNB acceptable or better than post-surgical pain (68.3%), and would choose it again in future.

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