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Updated: Jun 20, 2026
Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
Published on: November 21, 2025
Continuous peripheral nerve blocks for postoperative analgesia in children: feasibility and side effects in a cohort
Christophe Dadure1, Sophie Bringuier, Olivier Raux
1Department of Anesthesia and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France. c-dadure@chu-montpellier.fr
Insights
Continuous peripheral nerve blocks (CPNB) in children are safe and effective for postoperative pain management, particularly after orthopedic surgery. While minor issues like catheter problems and nausea can occur, major adverse events are rare with CPNB.
Area of Science:
- Pediatric Anesthesiology
- Regional Anesthesia
- Pain Management
Background:
- Continuous peripheral nerve blocks (CPNB) are increasingly utilized for pediatric postoperative analgesia.
- Limited data exists on adverse events associated with CPNB in a large pediatric cohort.
- This study evaluates the indications, efficacy, and safety of CPNB in children.
Purpose of the Study:
- To assess the indications for CPNB in pediatric patients.
- To evaluate the efficacy of CPNB for postoperative pain relief in children.
- To identify and analyze adverse events associated with CPNB in pediatric surgical patients.
Main Methods:
- A retrospective review of all CPNBs performed in children over a 5-year period at a single institution.
- Data collection included patient demographics, surgical indications, local anesthetic details, and postoperative outcomes.
- Pain assessment utilized the Children and Infants Postoperative Pain Scale (CHIPPS) and Visual Analog Pain Scale (VAS).
Main Results:
- 339 CPNBs were analyzed in 292 children undergoing orthopedic procedures, primarily hip/femur osteotomies and clubfoot repair.
- Optimal pain relief was achieved in most patients, with a median block duration of 61.6 hours.
- No major adverse events were reported; however, 45.1% experienced minor events, most commonly mechanical catheter issues (20.1%) and nausea/vomiting (14.7%).
Conclusions:
- CPNB is a feasible and effective method for prolonged analgesia in pediatric orthopedic surgery.
- In experienced hands, CPNB offers a favorable safety profile in children, with a low incidence of major complications.
- The most frequent adverse events are manageable and related to catheter mechanics or common postoperative symptoms.
Introduction:
Perioperative continuous peripheral nerve blocks (CPNB) are increasingly being used in children. Only one previous study has reported adverse events of CPNB in a high number of pediatric cases. We evaluated the indications, block efficacy, and adverse events related to CPNB in children.
Methods:
All CPNBs that were performed in children for postoperative analgesia over a 5-year period at the Montpellier University Hospital in France were included in this study. The first bolus dose and the continuous doses of local anesthetic were not standardized. In the postoperative period, demographic data, quality of analgesia, amount of rescue analgesic medication, child/parent satisfaction, and adverse events were recorded in our Departmental Regional Anesthesia registry.
Results:
A total of 339 catheters were evaluated in 292 children ASA physical status I to III. The median age was 8 yr (0.6-17 yr) and the median weight was 28 kg (7-116 kg). The main surgical indications were hip, femoral, or tibial osteotomies (44.5%) and club foot repair (27.4%). The local anesthetics used were either bupivacaine or ropivacaine. The mean volume of the local anesthetic bolus dose was 0.49 +/- 0.16 mL . kg(-1), and the mean regimen of local anesthetic continuous infusion was 0.11 +/- 0.04 mL . kg(-1) . hr(-1). The median duration of CPNB was 61.6 hr (range 0-264 hr). Pain relief, which was evaluated with the children at rest, was considered optimal in the majority of patients throughout the study period. The Children and Infants Postoperative Pain Scale (CHIPPS) was used in children age 0-6 yr and the Visual Analog Pain Scale (VAS) was used in children 7 yr and older. There were no major adverse events. There were 211 minor adverse events recorded in 153 CPNBs (45.1%). The most frequently reported complication (20.1%) involved mechanical problems with the catheter, followed by nausea and vomiting (14.7%).
Conclusion:
CPNBs are indicated after orthopedic surgery in children. Our results demonstrate that CPNBs are feasible in the pediatric setting, and in skilled hands, they promote prolonged analgesia in the majority of patients without major adverse events. The most common minor adverse events are catheter-related mechanical problems and postoperative nausea and vomiting.
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