Postoperative outcomes of peripheral nerve block versus general endotracheal anesthesia for orthopedic upper limb surgery among pediatric patients: cohort study
Abstract
Background. Compared to adult patients undergoing upper limb surgery who receive general endotracheal anesthesia (GETA), those who receive peripheral nerve block (PNB) have better postoperative outcomes.
Objective. To compare postoperative outcomes of PNB and GETA for orthopedic upper limb surgery among pediatric patients.
Design. Cohort study.
Setting. Southern Philippines Medical Center, Davao City, from December 2015 to May 2016.
Participants. 94 boys and girls, 3 to 18 years old, who received either PNB or GETA for orthopedic upper limb surgery.
Main outcome measures. Postoperative pain by visual analogue scale (VAS), need for postoperative rescue opioid doses.
Main results. Of the 94 patients in this study, 47 (50%) received PNB, and the rest received GETA prior to surgery. Patients in the two anesthesia groups were comparable at baseline. The PNB group had lower mean VAS scores compared to the GETA group both at the post-anesthesia care unit (0.70 ± 1.52 versus 4.15 ± 1.78; p<0.001) and at the Orthopedics Ward (0.45 ± 1.49 versus 4.13 ± 1.68; p<0.001). The proportion of patients given postoperative rescue opioid doses was significantly lower in the PNB group (6/47; 12.77%) than in the GETA group (21/47; 44.62%; p=0.0006).
Conclusion. Pediatric patients for orthopedic upper limb surgery who received PNB had less pain postoperatively and needed postoperative rescue opioid doses less frequently compared to those who received GETA.
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