Burns
Conditions
Keywords
burn, skin graft donor site, analgesia for donor site
Brief summary
The purpose of this study is to determine whether either a peripheral nerve block under ultrasound (u/s) guidance of the lateral femoral cutaneous nerve (LFCN), versus an u/s guided block of the nerve followed by continuous catheter infusion of local anesthetic, offers better post-operative analgesia in pediatric burn patients undergoing reconstructive surgery, than the current analgesic regimen of subcutaneous local anesthetic infiltration. Eligible subject, pediatric patients having reconstructive surgery for burns, having skin graft donor sites of the lateral thighs, will be randomized into three groups: control (having local infiltration of site), ultrasound guided nerve block, or ultrasound guided nerve block with catheter placement --fascia iliac. Post-operative comfort will be assessed over the next 48 hours.
Interventions
PROCEDURERegional nerve block
a block of the lateral femoral cutaneous nerve is performed under ultrasound guidance. For LFCN block, ropivacaine 0.2% will be used. Dose will be 20 ml, unless patient weighs less than 20 kg, in which case volume will be equal to patient's weight in kilograms.
PROCEDURECatheter
After an ultrasound guided nerve block is performed a catheter is placed under the fascia iliaca and an infusion of ropivacaine 0.2% running at 0.15 ml/kg/hour is administered for 48 hours.
Sponsors
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
2 Years to 21 Years
Healthy volunteers
No
Inclusion criteria
* going for reconstructive surgery requiring split thickness skin graft * patient's donor site will be in distribution of lateral femoral cutaneous nerve * age \>=2 and \<22 * patient emotionally/intellectually able to describe intensity of post-op pain using VAS or Wong- Baker faces scale.
Exclusion criteria
* potential block/catheter site infected or burned. * intolerance/allergy to local anesthetics * BMI \> 30 * American Society of Anesthesiologists (ASA) score \> 2
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Pain Scale | Q4 hours,while awake, for 48 hours | We will assess a VAS of pain (0-10)--every 4 hours postoperatively while the patient is awake, for 48 hours post-op. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Narcotic use | 48 hours postoperative | We will record narcotic requirements of the subjects over the 48 hours post operatively. |
Countries
United States
Outcome results
None listed