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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Catheter | Experimental | An ultrasound guided block of the LFCN is performed, followed by the placement of a catheter underneath the fascia iliaca. |
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| Ultrasound guided LFCN block | Experimental | An ultrasound guided regional nerve block --using ropivacaine 0.2%-- will be performed around the lateral femoral cutaneous nerve (LFCN). |
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| Control | No Intervention | This group gets the current standard of care--the donor site is infiltrated with 0.25% bupivacaine. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Regional nerve block | Procedure | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Pain Scale | We will assess a VAS of pain (0-10)--every 4 hours postoperatively while the patient is awake, for 48 hours post-op. | Q4 hours,while awake, for 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Narcotic use | We will record narcotic requirements of the subjects over the 48 hours post operatively. | 48 hours postoperative |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Erik S Shank, MD | Partners Health Care | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shriners Hospital for Children | Boston | Massachusetts | 02114 | United States |
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| ID | Term |
|---|---|
| D002056 | Burns |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| D057785 | Catheters |
| ID | Term |
|---|---|
| D004864 | Equipment and Supplies |
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| Catheter | Procedure | 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. |
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