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The efficacy of pre‐ versus postsurgical axillary block on postoperative pain in paediatric patients
Author(s) -
Altintas Fatiş,
Bozkurt Pervin,
İpek Neval,
Yücel Akin,
Kaya Güner
Publication year - 2000
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2000.00426.x
Subject(s) - medicine , analgesic , anesthesia , bupivacaine , surgery , forearm , randomized controlled trial
Summary We compared the effects of pre‐ and postsurgical axillary block on pain after hand and forearm surgery in 55 children in a double‐blind randomized study. The successful blocks are reported here ( n =49). Children aged 1–11 years and ASA I or II were allocated randomly to receive axillary block with 2 mg.kg −1 of 0.25% bupivacaine, either after induction but before the surgery (presurgical group, n =25) or immediately after surgery, before the end of anaesthesia (postsurgical, n =24). In all patients, a standard general anaesthesia technique was used. The Faces Pain Scale (FPS) and analgesic requirements were recorded for 24 h at various times after operation. Eight patients (32%) in the presurgical group and 20 patients (83.33%) in the postsurgical group did not require additional analgesic within the first 24 h after operation ( P < 0.05). In patients who had pain during the observation period, the pain started 13.66±2.61 h in the presurgical group and 13.14±2.34 h in the postsurgical group after performing block ( P > 0.05). The FPS scores were similar in both groups during the first 8 h in the postoperative period ( P > 0.05). There was a significant difference at 10 h after surgery ( P < 0.05). Cumulative FPS score was higher in the presurgical group (10.50±1.06) than in the postsurgical group (9.45±1.28) ( P < 0.05), but both groups had effective analgesia overall, the mean FPS score being less than 2. Additional analgesic consumption was similar in these patients in both groups. A lower isoflurane concentration was used in the presurgical group (0.68% vs 1.72%, P < 0.001). We did not demonstrate the superiority of preemptive analgesia, but our results indicate that presurgical axillary block with 0.25% bupivacaine allows the use of inhalational anaesthetics at lower concentrations while providing a reasonably painless postoperative period.