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POPLITEAL BLOCK FOR LOWER LIMB SURGERY IN CHILDREN WITH CEREBRAL PALSY: EFFECT ON SEVOFLURANE CONSUMPTION AND POSTOPERATIVE PAIN
ESRA Academy. Ozkan D. Sep 8, 2016; 138467
Topic: REGIONAL ANAESTHESIA (RA) TECHNIQUES - CLINICAL IMPLICATIONS
Dr. Derya Ozkan
Dr. Derya Ozkan

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Abstract
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Background and Aims:

Children with cerebral palsy (CP) require functional orthopedic interventions due to soft tissue releases, lengthening, or reconstruction of bone deformities. Popliteal block is utilized in below-knee operations under ultrasonography guidance for anesthesia or analgesia purposes.

Methods:

Fifty four patients undergoing lower limb surgery  were randomized to receive popliteal block- general anesthesia (Group P, n=27) or general anesthesia (Group C, n=27). After inhalation anesthesia with 50% N2O, O2 and 8% sevoflurane, in Group P, popliteal block was performed  with 0.3ml/kg of 0.250% bupivacaine. The Group C received no  popliteal block. Skin conductance fluctuations peak per sec values and the Wong Baker faces scale (WBFS) values of the patients were recorded upon arrival at the PACU  (Tp0), at the 10th min (Tp10), 20th min (Tp20), 1st hour (Tp1), 4th hour (Tp4), 12th hour (Tp12) and the 24th hour (Tp24) in ward. Total paracetamol consumption of the patients were also recorded.

Results:

The ET-sevoflurane concentration values were significantly higher in group C than the group P all assesment time periods except 5 min after induction of anesthesia (p<0.001). SCF peak numbers per sec and WBFS scores were significantly higher in goup C than the group P in all assessment times (p<0.001) except in Tp 24 time period.  Total  paracetamol consumption was 508.7 ± 122.7 mg in group P and 816.6 ± 166.5 in group C (p<0.001)

Conclusions:

Popliteal block is effective for  postoperative analgesia and decreases the paracetamol consumption in children with CP undergoing lower limb surgery. The sevoflurane requirement also decreases with popliteal block.

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