Ultrasound Guided Distal Adductor Canal Block for Pediatric Lower Limb Surgery
Objective: Surgery applied for musculoskeletal system deformities is a major surgery that causes severe postoperative pain. This situation is related to physiological and psychological side effects, especially in pediatric patients. Distal adductor canal block was applied in adults, and sensory block of sciatic and femoral nerves has been demonstrated. This block may provide adequate analgesia after pediatric lower extremity surgery. Method: We performed distal adductor canal block in a five-year-old pediatric patient who underwent Ilizarov external fixation with fibular and tibial osteotomy. During postoperative 24-hour, pain scores and additional analgesic requirement were recorded. Results: Postoperative 24-hour pain scores were between 0-2 points, patient slept well, and did not require additional analgesics for 16 hours after the procedure. Conclusion: Distal adductor canal block may provide effective postoperative analgesia for lower limb surgery in pediatric cases with blockage of two nerves with a single injection.
Pediyatrik Alt Ekstremite Cerrahisi için Ultrason Eşliğinde Distal Adduktor Kanal Bloğu
Amaç: İskelet kas sistemi deformitesi cerrahisi, postoperatif ciddi ağrıya neden olan major ameliyatlardır. Bu durum, özellikle pediyatrik hastalarda fizyolojik ve psikolojik yan etkilerle ilişkilidir. Distal addüktör kanal bloğu yetişkin hastalarda uygulanmış, femoral ve siyatik sinirde duyusal blokaj sağladığı gösterilmiştir. Bu blok, pediyatrik alt ekstremite cerrahisinde de yeterli analjezi sağlayabilir. Yöntem: Fibular ve tibial osteotomi ile Ilizarov eksternal fiksatörü uygulanan beş yaşındaki pediyatrik hastaya postoperatif distal adductor kanal bloğu uygulandı. Postoperatif 24 saatlik ağrı skorları ve ek analjezik gereksinimi değerlendirildi. Bulgular: Postoperatif 24 saatlik ağrı skorları 0-2 arasındaydı, hasta iyi uyudu ve işlemden sonra 16 saat boyunca ek analjezik gereksinimi olmadı. Sonuç: Distal addüktör kanal bloğu, pediyatrik alt ekstremite cerrahisi için tek 1 enjeksiyon ile 2 siniri bloke ederek etkili postoperatif analjezi sağlayabilir.
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