title: Popliteal block for lower limb surgery in children with cerebral palsy: effect on sevoflurane consumption and postoperative pain (a randomized, double-blinded, controlled trial).
abstract: OBJECTIVE
  The aim of this study was to evaluate the effects of a preoperative popliteal block on sevoflurane consumption, postoperative pain, and analgesic consumption in children with cerebral palsy (CP) following lower limb surgery.
  
  
  METHODS
  Fifty-four patients undergoing lower limb surgery were randomized to receive either a popliteal block + general anaesthesia (group P, n = 27) or general anaesthesia without a popliteal block (group C, n = 27). After anesthesia induction with 50% N2O, O2, and 8% sevoflurane, a popliteal block was given to group P patients with ultrasound guidance as a single dose of 0.3 ml/kg body weight of 0.25% bupivacaine. Group C patients received the same regimen of anesthesia induction but no preoperative popliteal block. Both the conductance fluctuation (SCF) peak numbers per second and the Wong-Baker FACES® Pain Rating Scale (WBFS) values of the patients were recorded upon arrival at the PACU, at 10 and 20 min after arrival at the PACU, and at postoperative hours 1, 4, 8, 12, and 24 when they were in the ward. The total paracetamol consumption of the patients was also recorded.
  
  
  RESULTS
  The end-tidal sevoflurane concentration values were significantly higher in group C patients than in group P patients, except for at 5 min after induction of anaesthesia (p < 0.001). The SCF peak numbers per second and WBFS scores were significantly higher in group C patients than in group P patients, except at Tp24h (p < 0.001). The total paracetamol consumption was 489.7 ± 122.7 mg in group P patients and 816.6 ± 166.5 in group C patients (p < 0.001).
  
  
  CONCLUSIONS
  Popliteal block is effective for postoperative analgesia, decreasing the paracetamol consumption and sevoflurane requirement in children with CP undergoing lower limb surgery. Trial registration ClinicalTrial.gov identifier: NCT02507700.
authors.affiliation: Anesthesiology and Reanimation Department, Ministry of Health Diskapi Yildirim Beyazit Training and Research Hospital, Diskapi, 06110, Ankara, Turkey. derya_z@yahoo.com.
authors.forename: Derya
authors.identifier: http://orcid.org/0000-0002-8964-3015
authors.initials: D
authors.lastname: Ozkan
authors.affiliation: Orthopedics and Traumatology Department, Ministry of Health Diskapi Yildirim Beyazit Training and Research Hospital, Diskapi, 06110, Ankara, Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Gonen
authors.affiliation: Anesthesiology and Reanimation Department, Ministry of Health Diskapi Yildirim Beyazit Training and Research Hospital, Diskapi, 06110, Ankara, Turkey.
authors.forename: Taylan
authors.initials: T
authors.lastname: Akkaya
authors.affiliation: Anesthesiology and Reanimation Department, Ministry of Health Diskapi Yildirim Beyazit Training and Research Hospital, Diskapi, 06110, Ankara, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Bakir
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D000293:Adolescent; D000768:Anesthesia, General / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology*; D011446:Prospective Studies; D000077149:Sevoflurane
chemical_list: D008738:Methyl Ethers; D000082:Acetaminophen; D000077149:Sevoflurane; D002045:Bupivacaine
keywords: Cerebral palsy; Face scale score; Pain monitor; Popliteal block