Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Regional anesthesia for pediatric knee surgery reduces pain, speeds recovery

13.08.2014

A recent study of an ultrasound-guided regional anesthesia technique, called femoral nerve block, shows that it leads to less opioid use and allows the majority of patients to go home within hours of surgery. As many as 98 percent of all pediatric knee surgeries performed at Nationwide Children's Hospital were done in an outpatient setting, as a result of this method that reduces post-operative pain and speeds recovery.

"Our goal with this technique is to reduce pain, which improves patient outcomes and patient satisfaction," said Tarun Bhalla, MD, director of Acute Pain and Regional Anesthesia at Nationwide Children's and a co-author of the study. "We also use fewer pain medicines intraoperatively as well as postoperatively, so we could really avoid a lot of the side effects that come along with them. We're localizing our numbing medicine to the area where the incision is being made to keep the coverage localized."

Anesthesiologists use ultrasound to guide a needle to the specific surgical site and deliver local anesthetic to numb only the nerves in that region. A femoral nerve block numbs the femoral nerve, which runs close to the femoral artery and conducts signals running along the front of the thigh, the inner leg and the foot.

By numbing this nerve, all feeling to those regions is blocked. The anesthetic blocks pain for up to 12 hours in some cases, significantly reducing post-operative pain. Following surgery, patients have a catheter that runs to the surgical site. The catheter is connected to an exterior pump that delivers anesthetic to the area for up to three days after surgery, while the patient is at home.

The study also showed for patients who did require hospitalization spent fewer days inpatient as a result of ultrasound-guided regional anesthesia.

"With a significant reduction of inpatient stays, patients are going home within a couple hours after coming out of surgery and they have an easier recovery," Dr. Bhalla said. "I think the quality of recovery is much better because the patients are so much more comfortable at home and not surrounded by the sounds of hospital machines."

For the study, which was published in a recent issue of the Journal of Pediatric Orthopedics, researchers reviewed records of 376 patients age 7 to 18 years old who underwent arthroscopic knee surgery at Nationwide Children's between July 2008 and July 2011. Of these patients, 131 received a femoral nerve block in addition to general anesthesia, while 245 received general anesthesia alone.

Patients who received the combined anesthesia reported less pain, required less pain medication after surgery and had shorter hospital stays when compared to patients who had general anesthesia alone. This includes 98 percent of ACL reconstructions, which are considered to be one of the most painful of all procedures evaluated in the study.

"It's a safe procedure that's markedly improved our ability to perform outpatient surgical services and in fact, it's become very rare for us to have any overnight stays for knee reconstruction," said Kevin E. Klingele, MD, chief of Orthopedics at Nationwide Children's and a co-author of the study.

While this study looked specifically at arthroscopic knee surgery, regional anesthesia is also becoming more widely used in orthopedic procedures in the shoulder, elbow and wrist and in other surgical procedures in the abdomen. Regional anesthesia is being used in cardiac and urological surgeries as well.

"Ultrasound-guided regional anesthesia is being used more regularly in pediatric patients, and more often in younger and younger patients," said Dr. Bhalla, also director of the Pediatric Regional Anesthesia fellowship at Nationwide Children's and a faculty member at The Ohio State University College of Medicine. "One of the most significant side effects of opioid use in infants is depressed respiratory function, which leads many infants to require intubation. Reducing the need for narcotics helps the infants come off ventilation more quickly."

Nationwide Children's is one of 13 medical centers nationwide participating in the Pediatric Regional Anesthesia Network, or PRAN, a collaboration designed to support the collection of highly audited data on practice patterns and complications and to facilitate collaborative research in regional anesthetic techniques in infants and children. Participating institutions report the number of regional anesthesia procedures they do each month.

"Since 2010, we have significantly increased the number of blocks we are doing and now perform 150 and 200 a month," said Dr. Bhalla, who travels around the country and the world teaching other medical centers how to do these procedures in pediatric patients. "Of course, it's reduced cost to patients and families, reduced cost to insurance companies. So, it really is a whole benefit for the community and improves the experience for our patients."

Gina Bericchia | Eurek Alert!
Further information:
http://www.nationwidechildrens.org

Further reports about: Nationwide Pediatric anesthesia anesthetic catheter effects knee pain surgery

More articles from Health and Medicine:

nachricht New study points the way to therapy for rare cancer that targets the young
22.11.2017 | Rockefeller University

nachricht Penn study identifies new malaria parasites in wild bonobos
21.11.2017 | University of Pennsylvania School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

UCLA engineers use deep learning to reconstruct holograms and improve optical microscopy

22.11.2017 | Medical Engineering

Watching atoms move in hybrid perovskite crystals reveals clues to improving solar cells

22.11.2017 | Materials Sciences

New study points the way to therapy for rare cancer that targets the young

22.11.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>