Ultrasound guided Adductor canal block (ACB) for acute postoperative pain management in pediatric patients undergoing distal femur and knee surgeries : A comparative study with caudal analgesia / Chahenda Tarek Bassiouni Salem ; Supervised Nevin Mahmoud Gouda , Mohamed Ahmed Selim , Ramy Mohamed Alkonaiesy

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anesthesia

In the past years, pediatric applications of plexus and conduction nerve blocks have increased considerably.The adductor canal block (ACB) in children has been reported as an effective technique for postoperative analgesia following distal femur and knee procedures. This study was done to compare between ACB and caudal block with ultrasound guidance as regards degree of intra and postoperative pain relief, effect on hemodynamics and incidence of complications. Forty four patients were recruited to undergo distal femur and knee surgeries and divided into two groups randomly.Their age ranged from 1 to 12 years old from both genders. General anesthesia was induced, blocks was given. All patients received diclofenac sodium 1mg/kg suppository intraoperative. Afterthe surgical procedure, quality of analgesia assessed immediately postoperative and then at 2, 4, 6, 8, 12 and 24 hours postoperatively using CHEOPS pain score. All patients received postoperative diclofenac sodium suppositories 1 mg/ kg divided tid every 8 hours. Morphine IV is given as rescue analgesia (0.005 mg/kg) when needed. Failure of block was definedand excluded from the study. Our study, as regards total morphine consumption postoperativelyshowed significant differences between the two groups in favour of ACB. Both blocks under ultrasound guidance proved to be safe with no recorded complications either intra or postoperatively

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