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

The registry criteria, word for word

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

• Are you between 3 and 18 years old?YesNo

What the trial wants to find out

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.

The 2 groups in the trial

• Adductor Canal Block + Popliteal Sciatic Nerve Block GroupExisting treatment, for comparison

  Participants assigned to this group will undergo general anesthesia followed by ultrasound-guided combined popliteal sciatic nerve block and adductor canal block. Both blocks will be performed after induction of general anesthesia using 0.25% bupivacaine, with a total local anesthetic volume of 0.5 mL/kg (maximum volume 20 mL). Before the end of surgery, all participants will receive intravenous acetaminophen (paracetamol) at a dose of 15 mg/kg. Postoperative pain will be assessed using the revised Face, Legs, Activity, Cry, and Consolability (r- FLACC) scale at 1, 2, 6, 12, and 24 hours after surgery. If the r- FLACC score is greater than 3, intravenous morphine 25 µg/kg will be administered in the post-anesthesia care unit, or oral ibuprofen 10 mg/kg will be administered in the inpatient ward.

• Control GroupExisting treatment, for comparison

  Participants assigned to this group will undergo general anesthesia without peripheral nerve block. Intravenous paracetamol at a dose of 15 mg/kg will be administered intraoperatively as part of the standard analgesic protocol. If the postoperative r- FLACC score is greater than 3, intravenous morphine 25 µg/kg will be administered in the post-anesthesia care unit, or oral ibuprofen 10 mg/kg will be administered in the inpatient ward.