Abstract：
Optimal pain management after insertion of a central venous catheter in children remains unclear.
This study aimed to evaluate the effects of a selective supraclavicular nerve block on postoperative analgesia in pediatric patients undergoing hickman catheter or chemoport insertion.
Fifty patients aged 3-18 years scheduled for elective Hickman or chemoport insertion were randomized into two groups of 25 each: one group received an ultrasound-guided selective supraclavicular nerve block with 0.1 mL/kg of 0.5% ropivacaine (SSCNB group), and the other group did not receive a nerve block (control group). The primary outcome was the postoperative Wong-Baker Faces Pain Rating Scale score measured between 10 and 30 min after surgery. Secondary outcomes included pain scores at 1, 3, and 24 h after the surgery, block-related complications, length of stay in the postanesthesia care unit, postoperative analgesic consumption, and time to first analgesic use 24 h after surgery.
The worst pain score within 30 min in the recovery room was significantly lower in the SSCNB group compared to the control group (6 [5-7] vs. 3 [2-4]; median difference, -3; 95% CI, -4 to -1; p < .001). Pain scores at 1, 3, and 24 h after surgery were also significantly lower in the SSCNB group. The need for both opioid and non-opioid analgesics in the postoperative period was significantly lower in the SSCNB group (36.0% vs. 0%; p = .002 and 44.0% vs. 16.0%; mean difference, -28%; 95% CI, -56 to 0.19; p = .033, respectively), while other secondary outcomes were not significantly different between the two groups.
Ultrasound-guided SSCNB is an effective method for managing postoperative pain in children undergoing Hickman catheter or chemoport insertion, reducing the need for analgesics within 24 h after surgery.
This study aimed to evaluate the effects of a selective supraclavicular nerve block on postoperative analgesia in pediatric patients undergoing hickman catheter or chemoport insertion.
Fifty patients aged 3-18 years scheduled for elective Hickman or chemoport insertion were randomized into two groups of 25 each: one group received an ultrasound-guided selective supraclavicular nerve block with 0.1 mL/kg of 0.5% ropivacaine (SSCNB group), and the other group did not receive a nerve block (control group). The primary outcome was the postoperative Wong-Baker Faces Pain Rating Scale score measured between 10 and 30 min after surgery. Secondary outcomes included pain scores at 1, 3, and 24 h after the surgery, block-related complications, length of stay in the postanesthesia care unit, postoperative analgesic consumption, and time to first analgesic use 24 h after surgery.
The worst pain score within 30 min in the recovery room was significantly lower in the SSCNB group compared to the control group (6 [5-7] vs. 3 [2-4]; median difference, -3; 95% CI, -4 to -1; p < .001). Pain scores at 1, 3, and 24 h after surgery were also significantly lower in the SSCNB group. The need for both opioid and non-opioid analgesics in the postoperative period was significantly lower in the SSCNB group (36.0% vs. 0%; p = .002 and 44.0% vs. 16.0%; mean difference, -28%; 95% CI, -56 to 0.19; p = .033, respectively), while other secondary outcomes were not significantly different between the two groups.
Ultrasound-guided SSCNB is an effective method for managing postoperative pain in children undergoing Hickman catheter or chemoport insertion, reducing the need for analgesics within 24 h after surgery.
摘要：
背景：在儿童中插入中心静脉导管后的最佳疼痛管理仍不清楚。
目的：本研究旨在评估选择性锁骨上神经阻滞对接受hikman导管或化学瓶插入的儿科患者术后镇痛的影响。
方法：将50名年龄3-18岁的患者随机分为两组，每组25人：一组接受超声引导的选择性锁骨上神经阻滞，0.1mL/kg的0.5％罗哌卡因（SSCNB组），另一组未接受神经阻滞（对照组）。主要结果是术后10至30分钟之间测量的Wong-Baker面部疼痛量表评分。次要结果包括术后1、3和24h的疼痛评分，阻滞相关并发症,在麻醉后监护室的停留时间，术后镇痛消耗，以及术后24h首次使用镇痛药的时间。
结果：与对照组相比，SSCNB组在恢复室30分钟内的最严重疼痛评分明显较低（6[5-7]vs.3[2-4]；中位数差异，-3；95%CI，-4至-1；p<.001）。SSCNB组术后1、3和24h的疼痛评分也明显降低。SSCNB组术后对阿片类和非阿片类镇痛药的需求显着降低（36.0％vs.0%；p=.002和44.0%与16.0%；平均差，-28%；95%CI，分别为-56至0.19；p=0.033），而其他次要结局两组间无显著差异.
结论：超声引导下的SSCNB是治疗接受Hickman导管或化疗的儿童术后疼痛的有效方法，在手术后24小时内减少对镇痛药的需要。
目的：本研究旨在评估选择性锁骨上神经阻滞对接受hikman导管或化学瓶插入的儿科患者术后镇痛的影响。
方法：将50名年龄3-18岁的患者随机分为两组，每组25人：一组接受超声引导的选择性锁骨上神经阻滞，0.1mL/kg的0.5％罗哌卡因（SSCNB组），另一组未接受神经阻滞（对照组）。主要结果是术后10至30分钟之间测量的Wong-Baker面部疼痛量表评分。次要结果包括术后1、3和24h的疼痛评分，阻滞相关并发症,在麻醉后监护室的停留时间，术后镇痛消耗，以及术后24h首次使用镇痛药的时间。
结果：与对照组相比，SSCNB组在恢复室30分钟内的最严重疼痛评分明显较低（6[5-7]vs.3[2-4]；中位数差异，-3；95%CI，-4至-1；p<.001）。SSCNB组术后1、3和24h的疼痛评分也明显降低。SSCNB组术后对阿片类和非阿片类镇痛药的需求显着降低（36.0％vs.0%；p=.002和44.0%与16.0%；平均差，-28%；95%CI，分别为-56至0.19；p=0.033），而其他次要结局两组间无显著差异.
结论：超声引导下的SSCNB是治疗接受Hickman导管或化疗的儿童术后疼痛的有效方法，在手术后24小时内减少对镇痛药的需要。
