Efficacy of ultrasound-guided lumbar plexus block in reducing emergence agitation in children undergoing hip surgery

TL;DR

Using ultrasound-guided lumbar plexus block with general anesthesia reduces emergence agitation in children after hip surgery.

Contribution

Demonstrates that adding a lumbar plexus block reduces emergence agitation and its severity in pediatric hip surgery.

Findings

EA incidence was 13.4% in the block group vs. 44.2% in the control group.

Severe EA occurred in 3.5% of the block group vs. 19.1% in the control group.

Postoperative pain scores were lower in the block group.

Abstract

Emergence agitation (EA) is a common and challenging postoperative problem in children. We aim to investigate the effect of ultrasound-guided lumbar plexus block on emergence agitation in children undergoing hip surgery.

This prospective, randomized, controlled study was conducted in children aged 1–6 year undergoing elective hip surgery. Subjects were randomly assigned to receive either ultrasound-guided lumbar plexus block combined with general anesthesia (Group Block, n = 172) or routine general anesthesia (Group Control, n = 172). The primary outcome was the incidence of EA at 30 min after emergence from general anesthesia, assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale. The secondary outcomes included the incidence of severe EA, postoperative pain evaluated by the Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) and the incidence of postoperative adverse complications.

The incidence of EA was significantly lower in Group Block than in Group Control (13.4% vs. 44.2%, p < 0.001). Group Block had a lower incidence of severe EA than Group Control (3.5% vs. 19.1%, p < 0.001). CHEOPS was lower in Group Block than in Group Control [mean (95%CI), 4.4(4.3–4.5) vs.4.9 (4.8–5.0), p < 0.001].

Ultrasound-guided lumbar plexus block could effectively decrease the incidence and severity of emergence agitation in children undergoing hip surgery.

Figures