title: One operator's experience of ultrasound guided lumbar plexus block for paediatric hip surgery.
abstract: Lumbar plexus block has been shown to be effective for providing postoperative analgesia after major hip surgeries in children. The goal of the study was to evaluate the feasibility of ultrasound guidance during lumbar plexus block in children undergoing hip surgery for congenital hip dislocation. After obtaining local institutional ethical committee approval and parental informed consent, ASA I or II, 1-6 years old children undergoing hip surgery were included into the study. Lumbar plexus block was performed after general anaesthesia using ultrasound guided Shamrock Method. Bupivacaine 0.25 % was used during block performance. Dose of the local anaesthetic was 1 ml/kg and the maximum dose was limited to 20 ml. In the postoperative period pain was assessed using modified CHEOPS (Children's Hospital Eastern Ontario Pain Scale) pain score. If pain score in the postoperative period exceeded 3, patients received IV paracetamol 15 mg/kg-1. Morphine 0.1 mg/kg-1IV was planned to administer if pain scores were still higher than 3 despite paracetamol treatment. 75 patients whose mean age was 47 months were enrolled into the study. All blocks were performed successfully and without complications. Mean time for the first analgesic is found as 10 h after surgery. Only one patient required morphine in the recovery unit and 23 patients received paracetamol. US guided lumbar plexus block using Shamrock Method is an effective technique for providing postoperative analgesia after hip surgeries in children and it's effect lasts for 8-12 h after surgery.
authors.affiliation: Department of Anaesthesiology and Reanimation, Kocaeli Üniversitesi, Umuttepe Kampüsü, 41380, Kocaeli, Turkey. yavuzgurkanmd@gmail.com.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Gürkan
authors.affiliation: Department of Anaesthesiology and Reanimation, Kocaeli Üniversitesi, Umuttepe Kampüsü, 41380, Kocaeli, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Aksu
authors.affiliation: Department of Anaesthesiology and Reanimation, Kocaeli Üniversitesi, Umuttepe Kampüsü, 41380, Kocaeli, Turkey.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kuş
authors.affiliation: Department of Anaesthesiology and Reanimation, Kocaeli Üniversitesi, Umuttepe Kampüsü, 41380, Kocaeli, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Toker
authors.affiliation: Department of Anaesthesiology and Reanimation, Kocaeli Üniversitesi, Umuttepe Kampüsü, 41380, Kocaeli, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Solak
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage; D000777:Anesthetics; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006615:Hip / Q000601:surgery*; D006801:Humans; D007223:Infant; D008160:Lumbosacral Plexus / Q000187:drug effects*; D008297:Male; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D010372:Pediatrics / Q000379:methods; D011184:Postoperative Period; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014463:Ultrasonography / Q000379:methods
chemical_list: D000701:Analgesics, Opioid; D000777:Anesthetics; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine
keywords: Lumbar plexus; Paediatric anaesthesia; Regional anaesthetic techniques; Regional techniques acute pain; Ultrasound machines equipment