Clinical Evaluation of Opioid-Free Pediatric Peripheral Nerve Block for Lower Extremity Surgery Without Sedation.

Abstract

Peripheral nerve blocks in pediatric patients are often performed under deep sedation to minimize uncooperative behavior. However, sedation may obscure the accuracy of clinical assessments. This study evaluated the clinical safety and efficacy of peripheral nerve block for lower extremity surgery without sedation in pediatric patients. Retrospective study METHODS: This study analyzed 71 peripheral nerve block procedures in 58 pediatric patients who underwent lower extremity surgery without sedation. Clinical outcomes, including Child Anxiety Meter-State score, visual analog scale score, operative time, anesthesia onset time, and complications, were assessed. Among the cases, 18 were in the pediatric group (mean age 10.0 ± 1.6 years) and 53 in the adolescent group (mean age 14.1 ± 1.2 years). CAM-S scores before PNB and VAS scores for PNB were higher in the pediatric group, but there was no statistical difference. The success rate of peripheral nerve block as a single-attempt procedure was 99%. One case of incomplete block was observed as a complication. No major complications were observed in pediatric patients aged 8 to 16 years who underwent peripheral nerve block with detailed explanation of the procedure and parental support. This approach increased the success rate of peripheral nerve block without sedation to 99% in lower extremity surgeries. It represents a new anesthetic option for patients who consent to undergo this procedure. Level 4.