Ultrasound‐guided selective supraclavicular nerve block for postoperative pain control in children receiving Hickman catheter or chemoport insertion: A randomized controlled trial
Jung‐Bin Park, In‐Sun Song, Pyo‐Yoon Kang, Sang‐Hwan Ji, Young‐Eun Jang, Eun‐Hee Kim, Ji‐Hyun Lee, Hee‐Soo Kim, Jin‐Tae Kim- Anesthesiology and Pain Medicine
- Pediatrics, Perinatology and Child Health
Abstract
Background
Optimal pain management after insertion of a central venous catheter in children remains unclear.
Aim
This study aimed to evaluate the effects of a selective supraclavicular nerve block on postoperative analgesia in pediatric patients undergoing hickman catheter or chemoport insertion.
Methods
Fifty patients aged 3–18 years scheduled for elective Hickman or chemoport insertion were randomized into two groups of 25 each: one group received an ultrasound‐guided selective supraclavicular nerve block with 0.1 mL/kg of 0.5% ropivacaine (SSCNB group), and the other group did not receive a nerve block (control group). The primary outcome was the postoperative Wong‐Baker Faces Pain Rating Scale score measured between 10 and 30 min after surgery. Secondary outcomes included pain scores at 1, 3, and 24 h after the surgery, block‐related complications, length of stay in the postanesthesia care unit, postoperative analgesic consumption, and time to first analgesic use 24 h after surgery.
Results
The worst pain score within 30 min in the recovery room was significantly lower in the SSCNB group compared to the control group (6 [5–7] vs. 3 [2–4]; median difference, −3; 95% CI, −4 to −1; p < .001). Pain scores at 1, 3, and 24 h after surgery were also significantly lower in the SSCNB group. The need for both opioid and non‐opioid analgesics in the postoperative period was significantly lower in the SSCNB group (36.0% vs. 0%; p = .002 and 44.0% vs. 16.0%; mean difference, −28%; 95% CI, −56 to 0.19; p = .033, respectively), while other secondary outcomes were not significantly different between the two groups.
Conclusions
Ultrasound‐guided SSCNB is an effective method for managing postoperative pain in children undergoing Hickman catheter or chemoport insertion, reducing the need for analgesics within 24 h after surgery.