Mejía-Terrazas GE, Zaragoza-Lemus G, Infante-Cosío G

Language: Spanish
References: 14
Page: 65-68
PDF size: 204. Kb.

ABSTRACT

Introduction: The surgery of hip can produce intense a post-operative pain. The use of intravenous opioids or in epidural infusion produces an amount of adverse effects in the boy that limit their utility. Due to this technical alternatives have looked for to provide a suitable post-operative analgesia as it is the blockade of the compartment of psoas. Material and methods: A group of 60 paediatric patients realized blockade to them of the compartment of psoas according to the technique of Hadzick (distance (0.5 x weight) + 20 mm), 2.5 anesthetic doses of mg/kg volume 0.5 mL/kg, realized blockade guided by neuroestimulator. Intensity of the pain to 4 was evaluated, 8 and 24 hours, presence of complications, duration of the analgesia and depth of plexus. Results: 60 patients included themselves did not appear complications in no patient, the intensity of the pain went of zero to the 4 and 8 hours and the 24 hours of 4 ± 1.7 points. The duration of the analgesia was of 20.7 ± 1.2 hours, the depth of plexus was of 2.8 ± 1 cm. Discussion: This is an effective and safe analgesic technique in the paediatric population during the first 24 post-operative hours in surgery of hip.

REFERENCES

1. Bonica J. Postoperative pain. In: Bonica J, ed. The management of pain. 4th ed. Philadelphia: Lea & Febiger, 2002:461-80.

2. Lloyd-Thomas AR. Pain management in pediatric patients. Br J Anaesth 1990;64:85-104.

3. Wood CE, Goresky GV, Klassen KA, et al. Complications of continuous epidural infusions for postoperative analgesia in children. Can J Anaesth 1994;41:613-20.

4. Veyckemans F. Bloqueos perimedulares en pediatría técnicas e indicaciones. En: Cavallieri S. Bloqueos perimedulares y manejo del dolor en pediatría. Clínicas Latinoamericanas de Anestesiología Intersistemas 2005.

5. Winnie AP, Ramamurthy S, Durrani Z. Plexus blocks for lower extremity surgery: New answers to old problems. Anesth Rev 1974;1:1-6.

6. Dalens B, Tanguy A, Vanneuville G. Lumbar plexus block in children Anesth Analg 1988:67:750-8

7. Chayen D, Nathan H, Chayen M. The psoas compartment block. Anesthesiology 1976;45:95-9.

8. Dadure C, Raux O, Gaudard P, Sagintaah M, Troncin M, Rochette A, Capdevila X. Continuous psoas compartment blocks after major orthopedic surgery in children: A prospective computed tomographic scan and clinical studies. Anesth Analg 2004;98:623-8.

9. Schuepfer G. Jo M. Psoas compartment block in children: Part I – description of the technique Pediatric Anesthesia 2005:15:461-64.

10. Hadzic A, et al. Textbook of regional anesthesia and acute pain management. 1st ed. New York. McGraw – Hill Companies. 2007.

11. Farny J, Drolet P, Girard M. Anatomy of the posterior approach to the lumbar plexus block. Can J Anaesth 1994;41:480-5.

12. Capdevila X, Coimbra C, Choquet O. Approaches to the lumbar plexus: Success, Risks, and Outcome Regional Anesthesia and Pain Medicine 2005:30:150-162

13. Buttner W, Finke W. Analysis of behavioral and physiological parameters for the assessment of postoperative analgesic demand in newborns, infants, and young children: a comprehensive report on seven consecutive studies. Paediatr Anaesth 2000;10:303-18.

14. Sciard D, Matuszczak M, Gebhard R, et al. Continuous posterior lumbar plexus block for acute postoperative pain control in young children. Anesthesiology 2001;95:1521-3.