A long-term continuous infusion via a sciatic catheter in a 3-year-old boy
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Published on: November 9, 2016
Giorgio Ivani1, Luigi Codipietro, Ferdinando Gagliardi
1Department of Anaesthesiology and Intensive Care Regina Margherita Children's Hospital, Turin, Italy. gioivani@libero.it
Insights
Continuous peripheral infusion of ropivacaine and clonidine provided complete pain relief for a pediatric patient with a foot amputation. This method eliminated the need for rescue analgesia during intensive care.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Neuropathic Pain
Background:
- Subtotal foot amputation in children presents significant pain management challenges.
- Effective analgesia is crucial for recovery and preventing chronic pain post-amputation.
Observation:
- A 3-year-old boy with subtotal right foot amputation received continuous peripheral infusion analgesia.
- A peripheral catheter was placed targeting the sciatic nerve using a lateral approach.
Findings:
- Continuous infusion of 0.2% ropivacaine and 0.12 microg/kg/h clonidine was administered for 21 days.
- Complete pain relief was achieved, with no need for rescue analgesia.
- The patient remained pain-free throughout intensive care, including during other treatments.
Implications:
- Continuous peripheral infusion demonstrates safety and efficacy in pediatric pain management.
- This technique offers a viable alternative to other analgesia methods in children.
- Further research into peripheral continuous infusions for pediatric pain is warranted.
Abstract:
We describe the case of a 3-year-old boy with a subtotal amputation of the right foot who received treatment for pain via a peripheral catheter positioned at the level of the sciatic nerve (lateral approach).We administered a continuous infusion of 0.2% ropivacaine, 0.4 mg x kg(-1) x h(-1) plus clonidine 0.12 microg x kg(-1) x h(-1) for 21 days. Pain relief was complete and the patient did not require any further rescue analgesia throughout the period even during medications and surgical treatment in our intensive care unit. We discuss the safety and efficacy of the use of a peripheral continuous infusion in children compared with other techniques of analgesia.
