Is the psoas compartment block effective in eliminating pain in children after hip surgery?

Abstract

BACKGROUND: Hip joint surgery is a highly traumatic surgical intervention. Currently, the anesthesia service in the clinic of H. Turner National Medical Research Center uses either prolonged epidural block with catheter placement in the lumbar spine at the L_III–L_IV level or prolonged intravenous analgesia as the main method of pain syndrome treatment after hip joint surgery. Moreover, the potential of prolonged psoas compartment block has not been considered until recently.

AIM: To evaluate the effectiveness of prolonged psoas compartment block for pain control in the early postoperative period after hip surgery in comparison with traditional methods of pain control.

MATERIALS AND METHODS: This study analyzed the results of postoperative analgesia in 14 children after 15 surgeries in the hip joint, including 3 patients with prolonged psoas compartment block, 9 with prolonged epidural block, and 3 who received postoperative analgesia with systemic analgesics. One patient with bilateral congenital hip joint dislocation was anesthetized with prolonged psoas compartment block after the first operation for the first time and with prolonged epidural block after the second similar operation but on the other leg for the second time. Analgesia efficacy was assessed using the Wong–Baker scale, FLACC behavioral scale, and visual analog scale.

RESULTS: All three patients with prolonged psoas compartment block required an addition of butorphanol tartrate (tramal) for good analgesia. Additional administration of opioid analgesics was not needed when a prolonged epidural block was initiated.

CONCLUSIONS: Due to the continued need for additional administration of butorphanol tartrate, when prolonged epidural block was available, the use of prolonged psoas compartment block in children for pain relief in the early postoperative period after hip surgery was not considered appropriate.

Keywords

hip dysplasia / postoperative analgesia / lumbar compartment block / prolonged epidural analgesia / children

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