Guidelines for treatment of acute pain in children – 
the consensus statement of the Section of Paediatric Anaesthesiology and Intensive Therapy of the Polish Society of Anaesthesiology and Intensive Therapy

Cettler, Maciej; Zielińska, Marzena; Rosada-Kurasińska, Jowita; Kubica-Cielińska, Anna; Jarosz, Konrad; Bartkowska-Śniatkowska, Alicja

doi:10.5114/ait.2022.118972

Cited by 17 publications

(25 citation statements)

References 141 publications

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“…Coherent with the literature, our experience established exercise-preserving and opioid-sparing pain management using PENG blocks in patients under five. Therefore, we settled on a safe and well-tolerated pediatric range of ropivacaine 0.3–0.5 mL of 0.2% ropivacaine [ 2 ]. We identify that the efficacy of PENG blocks has yet to be demonstrated in prospective clinical trials in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

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Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report

Domagalska

Wieczorowska‐Tobis

Reysner

et al. 2023

JPM

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Introduction: The Pericapsular Nerve Group (PENG) block is a novel technique that allows for analgesia of the anterior hip capsule via the articular branches of the accessory obturator nerve and femoral nerve, which have a significant role in the innervation of the hip capsule. A PENG (Pericapsular Nerves Group) blockade is effective in both adult and pediatric patients. However, no studies on patients under five are available in the literature. Herein, we describe our experience with two pediatric patients with hip dysplasia. Purpose: This study aimed to evaluate the analgesic effect of the pericapsular nerves group (PENG) in preschool children undergoing hip surgery. Patients and methods: This study included two patients, aged 4 and 2 years old, who were qualified for hip surgery. Spinal or general anesthesia with the addition of a PENG block was performed. During the procedure, the basic hemodynamic parameters were monitored. The pain was assessed using the FALCC (Face, Legs, Activity, Cry, Consolability scale) score. A dose of 15 mg/kg−1 of metamizole was administered if the FLACC score was 3. In the case of a score of 4 on the FLACC scale, the application of 0.2 mg/kg−1 of nalbuphine was ordered. Results: After the surgery, the patients received 15 mg/kg−1 IV paracetamol every 6 h to prevent rebound pain. The patient's hemodynamic parameters were stable and within normal range. In the first 24 h period, the FLACC scores from all patients ranged from 0 to 3. One patient required metamizole 12 h after surgery. No evidence of block complications was observed. Conclusions: This case series showed that the PENG block assured opioid-free pain management and provided adequate postoperative analgesia. However, we are convinced that future randomized, controlled trials are needed in this field.

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Section: Discussionmentioning

confidence: 99%

“…Perioperative pain management is paramount after pediatric hip surgery. Inadequate analgesia can lead to patient and parent dissatisfaction, longer recovery, and prolonged hospital stays [ 2 ]. Local anesthesia is beneficial because it relieves pain and reduces opioid side effects [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report

Domagalska

Wieczorowska‐Tobis

Reysner

et al. 2023

JPM

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“…On average, severe pain lasts up to several weeks after the surgery (4). Apart from the use of opioids and sedatives, the current standard of care has been regional analgesia (usually placement of an epidural catheter in the thoracic section for 3-5 days, intrapleural analgesia with intercostal nerves block or paravertebral block) (5)(6)(7)(8)(9)(10). It is connected with the necessity of prolonged hospitalisation in order to control severe pain, so early rehabilitation is difficult.…”

Section: Introductionmentioning

confidence: 99%

Intercostal nerve cryoanalgesia in the treatment of pain in patients operated on by the modified Nuss method with the BackOnFeet application—a new strategy to improve outcomes

et al. 2023

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“…Perioperative pain management is paramount after pediatric hip surgery. Inadequate analgesia can lead to patient and parent dissatisfaction, longer recovery, and extended hospital stays (2). Local anesthesia is beneficial because it provides adequate pain relief while reducing opioid side effects (3,4).…”

Section: Introductionmentioning

confidence: 99%

Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report

Domagalska¹,

Wieczorowska‐Tobis²,

Reysner³

et al. 2023

Preprint

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Introduction The Pericapsular Nerve Group (PENG) block is a novel technique that allows for analgesia of the anterior hip capsule via the articular branches of the accessory obturator nerve and femoral nerve, which have a significant role in the innervation of the hip capsule. PENG blockade is effective in both adult and pediatric patients. However, there are no studies in the available literature on patients under five years of age. Herein, we describe our experience with two pediatric patients with hip dysplasia. Purpose This study aimed to evaluate the analgesic effect of the pericapsular nerves group (PENG) in small children undergoing hip surgery. Patients and methods This study included two patients, aged 2 and 4 years old, who qualified for hip surgery. General or spinal anesthesia with the addition of a PENG block was performed. During the procedure, the basic hemodynamic parameters were monitored. After the surgery, the patients received 15mg/kg-1 iv paracetamol every 6 hours to prevent rebound pain. The pain was assessed using the FALCC score. The 15mg/kg-1 metamizole was administered if the FLACC score was 3. In the FLACC score 4, the application of 0,2mg/kg-1 Nalpain was ordered. Results The patient's hemodynamic parameters were stable and within normal range. FLACC scores from all patients ranged from 0 and 3 in the first 24 h period. One patient required metamizole 12 hours after surgery. No evidence of block complications was observed. Conclusions This case series showed that PENG block provided adequate postoperative analgesia and assured opioid-free pain management. However, we are convinced that future randomized, controlled trials are needed in this field.

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Guidelines for treatment of acute pain in children – the consensus statement of the Section of Paediatric Anaesthesiology and Intensive Therapy of the Polish Society of Anaesthesiology and Intensive Therapy

Abstract: CONSEQUENCES OF NOT TREATING PAIN IN CHILDRENin humans, the processes of central nervous system (CNS) maturation take a very long time (up to the age of 27-28 years), yet their highest activity is observed during pregnancy and in the first

Cited by 17 publications

References 141 publications

Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report

Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report

Intercostal nerve cryoanalgesia in the treatment of pain in patients operated on by the modified Nuss method with the BackOnFeet application—a new strategy to improve outcomes

Pericapsular Nerves Group (PENG) Block in Children under Five Years of Age for Analgesia in Surgery for Hip Dysplasia: Case Report

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