A Randomized Controlled Trial of Infraclavicular Nerve Blocks for Postoperative Pain Control in Operative Pediatric Lateral Condyle Fractures
University of California, Los Angeles
Summary
The purpose of this study is to investigate the post-operative pain control in pediatric patients with closed lateral condyle fractures who undergo open reduction and percutaneous pinning. Patients will be randomized into one of two groups. Group 1 will receive an infraclavicular nerve block to the affected extremity by a fellowship trained pediatric anesthesiologist prior to surgery. Group 2 will undergo the Orthopaedic Institute of Children's (OIC) standard preoperative protocol. Post-operative pain management will be the same for both groups per standard protocol. Pain level will be assessed post-operatively using the Wong-Baker FACES scale and parents will be asked to fill out a questionnaire regarding their satisfaction with the surgery and pain control. Parents will also fill out a medication log until the patient no longer requires pain medication. All patients in both groups will receive standard oxycodone solution prescriptions post-operatively as per typical protocol. The duration of participation in the study is approximately 1 week and requires 2 visits (time of recruitment at surgery and 1st post-op visit). This study is being conducted in hopes of developing comprehensive pain management protocols to reduce opioid consumption after surgical fixations of displaced lateral condyle fractures if the study can show that patients are more satisfied and require less opioid medication when receiving preoperative regional anesthesia.
Description
This is a double-blinded, randomized controlled trial evaluating the analgesic efficacy of infraclavicular regional blocks for postoperative pain control in patients following open reduction and percutaneous pinning for isolated closed lateral condyle fractures. Each patient will be evaluated initially at OIC's pediatric urgent care center and placed in a long arm splint with instructions to elevate the affected arm. Patients will not be discharged with any prescriptions for narcotic pain medication and will be instructed to take weight-based doses of acetaminophen and/or ibuprofen for pain co…
Eligibility
- Age range
- 4–12 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Isolated lateral condyle humerus fracture * Closed lateral condyle humerus fracture * Weiss classification type II and III (\>2mm displacement) lateral condyle fractures * Fractures treated with open reduction percutaneous pinning requiring fixation Exclusion Criteria: * Open fractures * Fractures with concomitant vascular or neurologic deficit * Pathologic fractures * Those presenting with concomitant injuries * Swelling requiring post-operative hospitalization for monitoring * Any known history of allergies to ropivacaine or oxycodone * Patients with developmental de…
Interventions
- DrugRopivacaine
Regional anesthesia protocol of open reduction percutaneous pinning of lateral condyle humerus fracture Ropivacaine
- OtherPuncture Wound and Dressing
No regional anesthesia is given for open reduction percutaneous pinning of lateral condyle humerus fracture
Location
- Orthopaedic Institute for ChildrenLos Angeles, California