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Continuous axillary nerve block for chronic pain

M S Fewtrell1, D J Sapsford, M J Herrick

  • 1Department of Paediatrics, Addenbrooke's Hospital, Cambridge.

Archives of Disease in Childhood
|January 1, 1994
PubMed
Summary
This summary is machine-generated.

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Continuous axillary nerve block effectively managed pain in a pediatric liver transplant patient with a chemical arm burn. This method allowed for successful extubation by replacing traditional pain management strategies.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Chemical burns in pediatric patients can cause severe pain, complicating recovery, especially after major surgery like liver transplantation.
  • Mechanical ventilation is often required for respiratory support in critically ill children, making effective pain control essential for weaning.
  • Axillary nerve blocks are regional anesthesia techniques used to manage upper extremity pain.

Observation:

  • A pediatric patient, post-liver transplantation and on mechanical ventilation, sustained a chemical burn to the arm.
  • Continuous axillary nerve block was administered to manage the acute pain associated with the burn injury.
  • Parenteral analgesia was being utilized prior to the nerve block implementation.

Findings:

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  • The continuous axillary nerve block provided sufficient analgesia to control the patient's pain.
  • The effective pain relief enabled the discontinuation of parenteral analgesia.
  • The improved pain and respiratory status facilitated the successful extubation of the patient.

    • Implications:

    • Continuous axillary nerve block is a viable and effective strategy for managing severe pain in critically ill pediatric patients with upper extremity injuries.
    • Regional anesthesia techniques can play a crucial role in facilitating recovery and reducing the need for systemic opioids in complex pediatric surgical cases.
    • This case highlights the potential of regional anesthesia to improve outcomes, including respiratory weaning, in challenging pediatric patient populations.