Intraarticular bupivacaine-clonidine-morphine versus femoral-sciatic nerve block in pediatric patients undergoing anterior cruciate ligament reconstruction

Kha M. Tran, Theodore J. Ganley, Lawrence Wells, Arjunan Ganesh, Kimberly I. Minger, Giovanni Cucchiaro

Research output: Contribution to journalArticlepeer-review

Abstract

We hypothesized that combined femoral-sciatic nerve block (FSNB) offers better analgesia with fewer side effects than intraarticular infiltration (IA) in children undergoing anterior cruciate ligament (ACL) reconstruction. Thirty-six children undergoing ACL reconstruction were randomized to FSNB or IA. FSNB patients had FSNB with bupivacaine (0.125%)-clonidine (2 μg/kg), whereas IA patients received bupivacaine (0.25%)-clonidine (1 μg/kg)-morphine (5 mg). Postoperatively, analgesia was provided with patient-controlled analgesia and rescue morphine. Patient demographics were similar. FSNB patients required less intraoperative fentanyl (50 ± 40 μg versus 80 ± 50 μg P = 0.04). Visual analog scale score for FSNB was smaller than IA in the recovery room (1.8 ± 3 versus 5.4 ± 3; P = 0.0002) and during the first 24 h (1.6 ± 1 versus 2.9 ± 2; P = 0.01)). FSNB morphine use in the first 18 h was less (7 ± 13 mg versus 21 ± 21 mg; P = 0.03). Fewer FSNB patients vomited (11% versus 50%; P = 0.03). IA patients required morphine patient-controlled analgesia sooner. After ACL reconstruction in children, FSNB with bupivacaine-clonidine provides better analgesia with fewer side effects than IA with bupivacaine-clonidine-morphine.

Original languageEnglish (US)
Pages (from-to)1304-1310
Number of pages7
JournalAnesthesia and analgesia
Volume101
Issue number5
DOIs
StatePublished - Nov 2005
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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