Pediatric anesthesia & critical care
Regional Anesthesia and Pain Outcomes After Anterior Cruciate Ligament Reconstruction Surgery in Pediatric Patients: Society of Pediatric Anesthesia Improvement Network
Authors' conclusion
Patients who received A+P PNB had lower postoperative pain scores than those who received no block.
Study context
- Population
- Adolescent patients undergoing anterior cruciate ligament reconstruction (ACLR)aged 15 years, 55.7% female
- Participants
- 519 patients
- Exposure
- Anterior PNB or anterior plus posterior PNB vs no PNB
- Outcome
- Acute postoperative pain outcomes (severe PACU pain scores)
Methodological detailsmultisite
- Multisite
Main finding
As reported in the abstract
Severe PACU pain scores
Observational data: associations, not effects.
Further findings
Intraoperative morphine equivalents
| Outcome | OR (95% CI) | |
|---|---|---|
| Severe pain scores (multivariable) · POD 1A+P PNB vs No PNB | 0.35 (0.15–0.84) | |
| POD 1 pain scores, LAC >0.25% vs lower LACHigher pain scores | 2.14 (1.1–4.16) | |
| 0.10.31310Odds ratio (log scale) |
Severe pain scores (multivariable) · POD 1
| OR (95% CI) | ||
|---|---|---|
| Hamstring autograft | 0.35 (0.15–0.83) | |
| 0.10.31310Odds ratio (log scale) |
Intraoperative morphine equivalents
- Significantly lower with anterior PNB (A-PNB) or A+P PNB vs no block
Total postanesthesia care unit (PACU) morphine equivalents
- Lower for any patient who received a PNB
POD 1 pain scores, local anesthesia concentration (LAC) >0.25% vs lower LAC
- PNB catheters associated with reduced POD 1 pain
Safety
Numbness (multivariable) · week 6
| OR (95% CI) | ||
|---|---|---|
| A-PNB with LAC >0.25% | 5.13 (1.27–20.8) | |
| 0.050.21520Odds ratio (log scale) |
Numbness with perineural steroid adjuvant · month 6
| OR (95% CI) | ||
|---|---|---|
| Dexamethasone | 5.93 (1.61–21.9) | |
| Methylprednisolone | 11.3 (2.16–58.6) | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Regional Anesthesia and Pain Outcomes After Anterior Cruciate Ligament Reconstruction Surgery in Pediatric Patients: Society of Pediatric Anesthesia Improvement Network. Anesth Analg. Published 29 January 2025. doi:10.
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