Epidural analgesia is superior to local infiltration analgesia in children with cerebral palsy undergoing unilateral hip reconstruction

Figures & data

Table 1. Baseline demographics and surgical data. Most values are median (range). There were no significant differences between groups

	LIA (n = 5)	Epidural (n = 6)	Placebo (n = 6)
Demographic data
Age, years	8 (5–13)	7.5 (5–11)	6.5 (3–10)
Weight, kg	20 (15–33)	20 (16–25)	16 (14–25)
Sex (M/F)	2/3	3/3	4/2
GMFCS (no. of patients)	IV:4; V:1	III:1; IV:2; V:3	IV:4; V:2
MP – side of surgery, %	65 (41–82)	59 (42–100)	58 (29–100)
MP – contralateral hip, %	31 (0–84)	24 (08–85)	26 (13–47)
AI – side of surgery	31 (19–35)	27 (22–39)	32 (24–36)
AI – contralateral hip	30 (5.2–37)	20 (12–33)	24 (13–31)
Surgical data
Side of surgery (right/left)	3/2	4/2	3/3
Blood loss, mL	300 (216–950)	250 (150–450)	350 (225–430)
Duration of surgery, min	190 (165–245)	228 (179–290)	233 (175–245)
Duration of anesthesia, min	300 (260–355)	325 (285–435)	323 (290–435)
Temperature (°C) ^a	36.9 (36.0–37.2)	36.9 (36.5–37.5)	37.5 (35.5–38.5)

a At the end of anesthesia.

GMFCS: gross motor function classification system;

MP: preoperative migration percentage.

AI: preoperative acetabular index;

Table 2. Postoperative pain and opioid consumption. Values are mean (SD)

	LIA	p-value^a	Epidural	p-value^b	Placebo	p-value^c
Perioperatively
No. of patients	4^d		6		6
Total opioid consumption, μg/kg/min	0.63 (0.15)	0.01	0.31 (0.17)	0.09	0.66 (0.42)	0.9
30-min opioid consumption, μg/kg/min^e	0.33 (0.18)	0.3	0.20 (0.16)	0.03	0.50 (0.25)	0.3
Epidural analgesia (n)^f	0		6		0
4 hours postoperatively
No. of patients	5		6		6
Opioid consumption, μg/kg	6.3 (2.8)	< 0.001	0.5 (0.7)	0.00	7.8 (3.1)	0.4
r-FLACC score, range 0–10	4.8 (3.0)	0.01	0.7 (0.8)	0.01	5.2 (3.3)	0.9
VAS-OBS score, range 0–10^g	5.2 (3.3)	0.02	0.6 (0.9)	0.00	6.5 (2.4)	0.5
Rescue epidural analgesia (n)^f	0		6		0
9 hours postoperatively
No. of patients	4		6		4
Opioid consumption, μg/kg	3.1 (0.3)	< 0.001	0.2 (0.3)	0.01	3.5 (1.3)	0.8
r-FLACC score, range 0–10	3.8 (2.2)	0.3	2.2 (2.0)	0.8	2.8 (2.0)	0.7
VAS-OBS score, range 0-10^g	3.3 (1.9)	0.2	1.4 (1.9)	0.05	5.3 (1.9)	0.3
Rescue epidural analgesia (n)^f	1		6		2
21 hours postoperatively
No. of patients	3		6		1
Opioid consumption, μg/kg	2.6 (1.0)		1.4 (2.3)		0
r-FLACC score, range 0–10	0.7 (1.2)		1.8 (2.1)		0
VAS-OBS score, range 0–10^g	1 (1)		0.8 (1.8)		4
Rescue epidural analgesia (n)^f	2		6		5

a Between LIA and epidural values.

b Between epidural and placebo values.

c Between placebo and LIA values.

d 1 patient was excluded immediately after surgery and 1 patient had missing perioperative opioid consumption data.

e 30-min opioid consumption: opioid consumption during the last 30 min of anesthesia.

f The epidural group received epidural analgesia perioperatively and during the study period. The LIA and placebo groups did not receive epidural unless it was needed as rescue analgesia.

g The parents of 1 patient were not able to use the VAS-OBS.