The efficacy of pre- versus postsurgical axillary block on postoperative pain in paediatric patients


Altintas F. , BOZKURT P., IPEK N. , YUCEL A., KAYA G.

PAEDIATRIC ANAESTHESIA, vol.10, no.1, pp.23-28, 2000 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 10 Issue: 1
  • Publication Date: 2000
  • Doi Number: 10.1046/j.1460-9592.2000.00426.x
  • Title of Journal : PAEDIATRIC ANAESTHESIA
  • Page Numbers: pp.23-28

Abstract

We compared the effects of pre- and postsurgical axillary block on pain after hand and forearm surgery in 55 children in a double-blind randomized study. The successful blocks are reported here (n = 49). Children aged 1-11 years and ASA I or II were allocated randomly to receive axillary block with 2 mg.kg(-1) of 0.25% bupivacaine, either after induction but before the surgery (presurgical group, n = 25) or immediately after surgery, before the end of anaesthesia (postsurgical, n = 24). In all patients, a standard general anaesthesia technique was used. The Faces Pain Scale (FPS) and analgesic requirements were recorded for 24 h at various times after operation. Eight patients (32%) in the presurgical group and 20 patients (83.33%) in the postsurgical soup did not require additional analgesic within the first 24 h after operation (P<0.05). In patients who had pain during the observation period, the pain started 13.66+/-2.61 h in the presurgical group and 13.14 +/- 2.34 h in the postsurgical group after performing block (P>0.05). The FPS scores were similar in both groups during the first 8 h in the postoperative period (P>0.05). There was a significant difference at 10 h after surgery (P<0.05). Cumulative FPS score was higher in the presurgical soup (10.50 +/- 1.06) than in the postsurgical group (9.45 +/- 1.28) (P<0.05), but both groups had effective analgesia overall, the mean FPS score being less than 2. Additional analgesic consumption was similar in these patients in both groups. A lower isoflurane concentration was used in the presurgical group (0.68% vs 1.72%, P<0.001). We did not demonstrate the superiority of preemptive analgesia, but our results indicate that presurgical axillary block with 0.25% bupivacaine allows the use of inhalational anaesthetics at lower concentrations while providing a reasonably painless postoperative period.