AI Article Synopsis
- Peripheral nerve blocks (PNBs) are commonly used in pediatric orthopedic surgery for pain management and quicker discharge, but they can lead to both short- and long-term complications.
- A systematic review identified 16 studies (10% of those reviewed) that discussed long-term complications following PNBs in pediatric patients, with 9 reporting issues such as chronic pain, motor deficits, and reduced range of motion.
- Overall, complications were noted in a small percentage of patients, with chronic pain occurring in 5%, strength deficits in 10%, and sensory deficits in just 0.07%.
Article Abstract
Background: Peripheral nerve blocks (PNBs) are frequently utilized as a regional anesthetic in pediatric orthopaedic surgery for postoperative pain control and reduced time to discharge; however, short- and long-term complications after these procedures are variably reported.
Purpose: To identify the frequency of long-term complications in pediatric patients who received regional anesthesia for a lower extremity orthopaedic procedure.
Study Design: Systematic review; Level of evidence, 4.
Methods: A systematic literature search was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were collected on pediatric patients, which included the following: block type, block location, procedure type, patient age, experimental design, and reported outcomes. Full texts were then thoroughly examined to determine whether the article made specific references to long-term (≥6 weeks) complications in pediatric patients who received PNBs.
Results: A total of 158 studies were assessed for eligibility. There were 16 of 158 (10%) studies that met inclusion criteria of having a discussion on follow-up to evaluate for long-term complications (≥6 weeks) from pediatric PNBs. Of these 16 studies, 9 documented long-term complications, while 7 reported no complications. The most common complications were motor deficits, chronic pain, reduced range of motion, and neurological paresthesia. Of the 9 studies reporting long-term complications related to PNBs, 16 of 352 patients across 2 studies (5%) reported chronic pain, 45 of 466 patients across 4 studies (10%) reported strength deficits, 16 of 135 patients across 2 studies (12%) reported reduced range of motion, and 11 of 15,387 patients across 4 studies (0.07%) reported sensory deficits.
Conclusion: Persistent complications occurred in pediatric orthopaedic patients undergoing lower extremity procedures with PNBs; however, reports in the current literature were rare.
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| http://dx.doi.org/10.1177/03635465241255606 | DOI Listing |
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