Epidural analgesia best option for kids after neuromuscular hip reconstruction?
A study showed that post-operative use of epidural analgesia in patients with neuromuscular conditions provided similar outcomes to traditional pain management regimens.
Sean Tabaie, M.D., pediatric orthopaedic surgeon and medical director of the motion capture lab at Children’s National Hospital, led a retrospective study to determine whether post-operative use of epidural analgesia in patients with neuromuscular conditions, such as cerebral palsy, provided similar outcomes with regard to pain scores, length of stay, duration of foley placement, duration of pain control and complications as compared to traditional pain management regimens.
The study showed that the use of epidural analgesia was associated with comparable pain scores, despite the increased length of stay and duration of Foley placement.
Why it matters
Neuromuscular conditions, such as cerebral palsy, are the most common motor disabilities in the pediatric population. Children with these conditions frequently have accompanying hip deformities that require pelvic and femur osteotomy to correct the spastic hip dislocations.
Studies suggest that children with cerebral palsy already experience twice as many complications and have high reoperation rates following hip surgery compared to their non-cerebral palsy counterparts. Therefore, to optimize outcomes in an already at-risk patient population – likely to undergo multiple procedures to correct musculoskeletal abnormalities – it is crucial to minimize opioid usage given its addictive nature and side effects such as constipation, sedation and tolerance.
Dr. Sean Tabaie
What’s next
“We believe the present study can serve as a foundation for future prospective and multi-center studies, which should aim to investigate dose and timing of epidural analgesia in children with neuromuscular conditions with a particular focus on surgical approach, side effects and time to return to activity,” says Dr. Tabaie.
Given the scarcity of data surrounding the use of epidural anesthesia in children with neuromuscular conditions, future research should seek to further investigate the efficacy of epidural analgesia for post-operative pain management in children with neuromuscular conditions.
You can read the full study “Use of Epidural Analgesia in Children With Neuromuscular Conditions Following Hip Reconstruction” in Cureus.
Authors on the study from Children’s National include Sean Tabaie, M.D.
