Pediatric anesthesia & critical care
Regional anesthesia and analgesia in patients with spastic cerebral palsy undergoing orthopedic surgery: a historical cohort study
Authors' conclusion
Despite the use of regional anesthesia, approximately 15% of patients with spastic CP undergoing orthopedic surgery for spastic cerebral palsy experienced severe pain that responded to treatment adjustments.
Study context
- Population
- Patients with spastic cerebral palsy undergoing orthopedic surgery of upper and lower extremities under combined RA and GA, April 2016 to February 2020440 analysed
- Participants
- 452 patients
- Outcome
- Incidence of severe postoperative pain
- Follow-up
- First 48 hr after surgery
Main finding
As reported in the abstract
Severe pain (reported by caregivers)
Patients with severe pain despite nonopioid analgesic interventions
68
15.5%
Observational data: associations, not effects.
Further findings
Types of RA applied
- Single-injection neuraxial anesthesia
- 241 (54.8%)
- Single-injection brachial plexus block
- 27 (6.1%)
- Single-injection femoral/sciatic nerve blocks
- 17 (3.9%)
- Continuous neuraxial block
- 149 (33.9%)
- Continuous brachial plexus block
- 4 (0.9%)
- Continuous femoral/sciatic nerve blocks
- 7 (1.6%)
- All patients received GA before block performance
Continuous catheter use by surgery complexity
- Major surgery: 161 (36.6%) patients; continuous catheters inserted
- 50.3%
- Complex major surgery: 72 (16.4%) patients; continuous catheters inserted
- 91.7%
Original publication
Regional anesthesia and analgesia in patients with spastic cerebral palsy undergoing orthopedic surgery: a historical cohort study. Can J Anaesth. Published 2 November 2023. doi:10.
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