Post Operative Pain Control After Pediatric Hip Surgery
Post Operative Pain Control After Pediatric Hip Surgery
Hip surgery in children is painful and the optimal modality for managing post-operative pain
 has not been established. This prospective randomized controlled trail compares lumbar plexus
 catheter (LPC), lumbar epidural catheter (LEC) and continuous patient-controlled analgesia
 with intravenous morphine (PCA).
Approximately 1 in 1,000 children born in the US have hip dislocation and 10 in 1,000 have
 hip subluxation requiring surgical intervention. Pain after major hip surgery in children is
 severe, yet there is no agreement on the most effective method for pain control.
 Post-operative pain modalities including lumbar epidural catheters (LEC), lumbar plexus
 catheters (LPC) and intravenous patient controlled analgesia (IV-PCA) have been described.
 IV-PCA has historically been the standard of care in spite of its numerous associated side
 effects. Regional anesthesia modalities have gained popularity because of superior pain
 control with lower opioid requirements.

 In this study, the investigators describe the first prospective randomized controlled trial
 comparing lumbar plexus catheter to alternatives for post-operative pain management in
 children after major hip surgery. The investigators hypothesized that LPC would be as safe
 and efficacious as LEC and IV-PCA with the added advantage of a decreased length of stay. The
 investigators primary aim was to compare hospital length of stay. Secondary aim was to
 compare pain scores, opioid consumption and opioid-related side effects.
Inclusion Criteria:

 -  children undergoing unilateral hip surgery, including pelvic innominate osteotomies,
 proximal femoral osteotomies, and arthrotomies (for open reduction, loose body
 removal, labral debridement or labral repair).

 Exclusion Criteria:

 -  history of a previous spine surgery, spina bifida, coagulopathy, skin infection,
 allergies to study medications (i.e. local anesthetics and opioids), patients taking
 opioids at the time of enrollment and, those having concurrent procedures distal to
 the hip