Ultrasound-Guided Block of the Lateral Femoral Cutaneous Nerve in Pediatric Patients

Study Overview
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Brief Summary
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The purpose of this study is to determine whether either a peripheral nerve block under ultrasound (u/s) guidance of the lateral femoral cutaneous nerve (LFCN), versus an u/s guided block of the nerve followed by continuous catheter infusion of local anesthetic, offers better post-operative analgesia in pediatric burn patients undergoing reconstructive surgery, than the current analgesic regimen of subcutaneous local anesthetic infiltration. Eligible subject, pediatric patients having reconstructive surgery for burns, having skin graft donor sites of the lateral thighs, will be randomized into three groups: control (having local infiltration of site), ultrasound guided nerve block, or ultrasound guided nerve block with catheter placement --fascia iliac. Post-operative comfort will be assessed over the next 48 hours.

Official Title
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Evaluation of Ultrasound-Guided Block of the Lateral Femoral Cutaneous Nerve in Pediatric Patients for Reconstructive Surgical Procedures

Conditions
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Burns

Intervention / Treatment
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* Procedure: Regional nerve block
* Procedure: Catheter


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: going for reconstructive surgery requiring split thickness skin graft patient's donor site will be in distribution of lateral femoral cutaneous nerve age >=2 and <22 patient emotionally/intellectually able to describe intensity of post-op pain using VAS or Wong- Baker faces scale. Exclusion Criteria: potential block/catheter site infected or burned. intolerance/allergy to local anesthetics BMI > 30 American Society of Anesthesiologists (ASA) score > 2

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Catheter<br>An ultrasound guided block of the LFCN is performed, followed by the placement of a catheter underneath the fascia iliaca. | Procedure: Regional nerve block<br>* a block of the lateral femoral cutaneous nerve is performed under ultrasound guidance. For LFCN block, ropivacaine 0.2% will be used. Dose will be 20 ml, unless patient weighs less than 20 kg, in which case volume will be equal to patient's weight in kilograms.<br>Procedure: Catheter<br>* After an ultrasound guided nerve block is performed a catheter is placed under the fascia iliaca and an infusion of ropivacaine 0.2% running at 0.15 ml/kg/hour is administered for 48 hours.<br>|
| Experimental: Ultrasound guided LFCN block<br>An ultrasound guided regional nerve block --using ropivacaine 0.2%-- will be performed around the lateral femoral cutaneous nerve (LFCN). | Procedure: Regional nerve block<br>* a block of the lateral femoral cutaneous nerve is performed under ultrasound guidance. For LFCN block, ropivacaine 0.2% will be used. Dose will be 20 ml, unless patient weighs less than 20 kg, in which case volume will be equal to patient's weight in kilograms.<br>|
| No Intervention: Control<br>This group gets the current standard of care--the donor site is infiltrated with 0.25% bupivacaine. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analog Pain Scale | We will assess a VAS of pain (0-10)--every 4 hours postoperatively while the patient is awake, for 48 hours post-op. | Q4 hours,while awake, for 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Narcotic use | We will record narcotic requirements of the subjects over the 48 hours post operatively. | 48 hours postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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burn, skin graft donor site, analgesia for donor site