Combined Popliteal and Adductor Canal Blocks for Postoperative Analgesia in Children With Cerebral Palsy

Postoperative Analgesic Efficacy of Combined Popliteal and Adductor Canal Blocks in Children With Cerebral Palsy Undergoing Lower Extremity Surgery: A Randomized Controlled Trial

This prospective, randomized, controlled trial aims to evaluate the postoperative analgesic efficacy of combined ultrasound-guided popliteal sciatic nerve block and adductor canal block in children with cerebral palsy undergoing elective lower extremity surgery. Children aged 3-18 years with American Society of Anesthesiologists (ASA) physical status II-III will be randomized into two groups. Participants in the intervention group will receive combined popliteal sciatic nerve block and adductor canal block in addition to general anesthesia, whereas participants in the control group will receive general anesthesia with intravenous analgesia without peripheral nerve block. Postoperative pain will be assessed using the revised Face, Legs, Activity, Cry, Consolability (r-FLACC) scale at 1, 2, 6, 12, and 24 hours after surgery by an anesthesiologist blinded to group allocation.

Inclusion Criteria:

• Pediatric patients aged 3-18 years
• Diagnosis of cerebral palsy
• Scheduled to undergo lower extremity surgery
• American Society of Anesthesiologists (ASA) physical status II-III
• Scheduled for elective surgery
• Written informed consent obtained from a parent or legal guardian

Exclusion Criteria:

• Age younger than 3 years or older than 18 years
• Coagulopathy or any contraindication to peripheral nerve block
• Known allergy to local anesthetics
• Infection at the planned block site