title: Hematoma block reduces narcotic pain medication after femoral elastic nailing in children.
abstract: Children with femur fractures can have severe pain after elastic nail fixation. The purpose of this paper is to test the effectiveness of an intraoperative hematoma block in controlling postoperative pain in children that underwent elastic nail fixation of isolated femur fractures. We compared 13 children who received an intraoperative bupivacaine hematoma block after elastic nail fixation of a femur fracture with a concurrent control group of 22 children with similar femur fractures that did not receive a hematoma block. The time to first narcotic dose after surgery was over 5 hours later in the hematoma block group versus the control group (P =.008). The hematoma block did not significantly lengthen the time of surgery. This study demonstrates that an intra-operative hematoma block is a simple, quick and effective method of postoperative pain control after elastic femoral nailing in children.
authors.affiliation: Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
authors.forename: José A
authors.initials: JA
authors.lastname: Herrera
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Wall
authors.forename: Susan L
authors.initials: SL
authors.lastname: Foad
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local; D002045:Bupivacaine; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D009407:Nerve Block / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002045:Bupivacaine