Ultrasound-guided femoral nerve block for pain control in an infant with a femur fracture due to nonaccidental trauma.
A 3-month-old infant girl was transferred to our emergency department (ED) with a subtrochanteric femoral neck fracture due to nonaccidental trauma. She received multiple doses of parenteral analgesics both before arrival and in our ED. We performed an ultrasound-guided femoral nerve block using 2.0 mL of 0.25% bupivicaine (approximately 1.25 mg/kg) before placing the patient in a Pavlik harness. Successful pain control was achieved within 15 minutes of the procedure allowing pain-free manipulation of the affected extremity. The patient required only a single dose of parenteral narcotics during the ensuing 18 hours. To our knowledge, this is the first report of an ultrasound-guided femoral nerve block used in the ED for pain control in a pediatric patient.
Department of Emergency Medicine, Alameda County Medical Center, Oakland, CA 94602, USA. oron.frenkel@gmail.com
Oron
O
Frenkel
Karim
K
Mansour
Jason W J
JW
Fischer
D059787:Acute Pain / Q000188:drug therapy / Q000628:therapy*; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local; D002045:Bupivacaine; D002649:Child Abuse / Q000175:diagnosis; D003131:Combined Modality Therapy; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D005267:Femoral Nerve; D005596:Fractures, Closed / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007223:Infant; D009104:Multiple Trauma / Q000000981:diagnostic imaging; D059352:Musculoskeletal Pain / Q000188:drug therapy / Q000628:therapy*; D009294:Narcotics / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D011859:Radiography; D018084:Ultrasonography, Interventional
D000779:Anesthetics, Local; D009294:Narcotics; D002045:Bupivacaine