Multimodal Injection for Postoperative Pain Control in Pediatric Patients With Cerebral Palsy .
Efficacy of a Multimodal Surgical Site Injection for Postoperative Pain Control in Pediatric Patients With Cerebral Palsy Undergoing Hip Reconstruction: A Randomized Controlled Trial.
J Pediatr Orthop . 2024 Nov-Dec;44(10):e921-e928.Thirty-four pediatric patients with cerebral palsy undergoing hip reconstruction were randomized to receive either a multimodal surgical site injection containing ropivacaine (3 mg/kg), epinephrine (0.5 mg), and ketorolac (0.5 mg/kg) (n=17) or a placebo injection of normal saline (n=17). The primary outcome of interest was total narcotic consumption, measured in morphine equivalents per kilogram (mEQ/kg). Secondary outcomes included mean postoperative pain scores, operative time, hospital length of stay, and adverse effects. Pain scores and narcotic use were recorded at multiple time points throughout hospitalization. Overall, the study revealed that patients receiving the multimodal injection had significantly lower narcotic consumption at all postoperative time points and lower pain scores throughout hospitalization. There were no significant differences in operative time, blood transfusion requirements, or hospital stay between groups. No adverse effects or injection site complications were reported. These findings suggest that multimodal local anesthetic injections should be incorporated into standard postoperative pain management for pediatric hip reconstruction in cerebral palsy patients.
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