Peri-operative Use of a Pain Injection Versus Epidural Anesthesia in Pediatric Patients With Cerebral Palsy

What this Trial Is About

Pain management is particularly challenging for pediatric patients with cerebral palsy (CP) due to communication difficulties and associated developmental and intellectual disabilities. This research evaluates and compares the effectiveness of a multimodal surgical site injection versus epidural anesthesia in controlling postoperative pain after hip surgery in children with CP. The study aims to improve pain control while reducing the risks associated with opioid use and epidural anesthesia in this vulnerable population. Participants will be assigned to receive either an injection of local anesthetics and analgesics including ropivacaine, epinephrine, and ketorolac, or lumbar epidural anesthesia using agents such as bupivacaine, lidocaine, and ropivacaine. The local anesthetic injection is given during surgery and aims to reduce pain at the surgical site while preserving motor function. The epidural anesthesia is administered intra-operatively and monitored by the anesthesia team. This randomized trial provides a direct comparison of these two pain management approaches following hip surgery. Throughout the study, researchers will measure postoperative narcotic use during the first 48 hours after surgery as the primary outcome. Secondary outcomes include pain scores over 2 to 4 days, hospital length of stay, and parent satisfaction assessed 2 to 3 weeks after surgery. Participants will be closely monitored for safety, with data collected on pain, medication use, and recovery progress. The total study duration includes the immediate postoperative period and follow-up assessments several weeks later.

Pain Injection Versus Epidural Anesthesia for Hip Surgery in Pediatric Patients With Cerebral Palsy