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[Continuous interscalenic nerve block in a 3 year old child after amputation of upper extremity]
A Gottschalk1, C Rempf, M Freitag
1Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg Eppendorf. gottschalk@uke.uni-hamburg.de
Insights
Pediatric extremity amputations require careful perioperative pain management to prevent phantom limb pain. A 3-year-old boy achieved complete pain relief for six days post-surgery using an interscalene catheter with ropivacaine infusion.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pediatric Oncology
Background:
- Extremity amputations in children present unique perioperative challenges.
- Effective pain management is crucial to prevent long-term psychological distress from phantom limb pain.
Observation:
- A 3-year-old boy underwent left arm disarticulation due to humerus osteosarcoma.
- Perioperative pain control was managed using a preoperatively placed interscalene catheter.
Findings:
- Continuous infusion of 0.2% ropivacaine via the interscalene catheter provided complete pain relief.
- This analgesic regimen was effective for the first six postoperative days.
Implications:
- Interscalene catheter infusion offers a viable strategy for managing acute postoperative pain in pediatric amputations.
- Minimizing acute pain may reduce the risk of developing chronic phantom limb pain and associated psychological sequelae in children.
Abstract:
Amputations of extremities, especially in the childhood, impose high demands on the perioperative management. Apart from the intraoperative care of these children, the postoperative pain therapy has to do one's utmost in the avoidance of the development of phantom limb pain, which can, especially in the childhood, be associated with far reaching psychological consequences. We report the case of a 3-year old boy who had to undergo exarticualtion of his left arm due to an osteosarcoma of the humerus. The perioperative pain management was performed by a preoperatively placed interscalene catheter and infusion of 0.2 % ropivacaine. Within the first six days postoperatively complete pain relief could be ensured with this analgetic regimen.
