Peripheral Nerve Blocks in Patients With Osteogenesis Imperfecta Undergoing Extremity Procedures are Safe and
Isaiah J Rhodes1, Timothy E Hereford1, Kesavan Sadacharam2
1Department of Orthopaedic Surgery, Nemours Children's Health, Wilmington, DE, USA.
Journal of the Pediatric Orthopaedic Society of North America
|October 20, 2025
Summary
Regional nerve blocks offer a safe and effective approach for managing postoperative pain in osteogenesis imperfecta (OI) patients undergoing extremity surgery. This method resulted in low pain scores and minimal opioid requirements, enhancing patient recovery.
Area of Science:
- Orthopaedic Surgery
- Pain Management
- Anesthesiology
Background:
- Limited data exists on regional nerve blocks for osteogenesis imperfecta (OI) patients undergoing extremity procedures.
- This study addresses the need for evidence on regional anesthesia in this specific patient population.
Purpose of the Study:
- To evaluate the safety and efficacy of regional nerve blocks in patients with OI undergoing reconstructive extremity surgery.
- To assess postoperative pain control and opioid utilization in OI patients receiving regional blocks.
Main Methods:
- Retrospective review of 90 surgical encounters in 58 OI patients (July 2018-September 2023).
- Data collected included demographics, OI type, procedures, block type, opioid use, pain scores, and complications.
- Analysis focused on outcomes associated with regional nerve blocks, primarily lumbar plexus blocks.
Main Results:
- Osteogenesis imperfecta type III was most common (35.6%).
- Femoral realignment and rodding were frequent procedures (26.6%).
- Regional blocks were associated with low intraoperative and postoperative opioid use (MME/kg), minimal pain scores (1.2-2.2), and no significant adverse events.
Conclusions:
- Regional nerve blocks, including those with indwelling catheters, are safe and effective for OI patients undergoing extremity procedures.
- This approach is linked to reduced postoperative pain and opioid consumption.
- Regional blocks should be considered a valuable component of multimodal pain management strategies for OI patients.
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