Comparing Multimodal Pain Injection and Epidural Anesthesia After Hip Surgery in Children with Cerebral Palsy
Led by University of California, Los Angeles · Updated on 2024-06-11
90
Participants Needed
4
Research Sites
26 weeks
Total Duration
AI-Summary
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.
CONDITIONS
Brief Title
Pain Injection Versus Epidural Anesthesia for Hip Surgery in Pediatric Patients With Cerebral Palsy
Research Team
R
Rachel M Thompson, MD
N
Nicole J Hung, MD
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This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
A targeted injection of ropivacaine, epinephrine, and ketorolac around the surgical site, designed to provide pain relief during and after hip surgery.
A lumbar epidural anesthesia protocol using combinations of bupivacaine, lidocaine, or ropivacaine, monitored by the anesthesia team for pain control during hip surgery.
Role in trial
Investigational approach to reduce pain and minimize opioid use after hip surgery in children with cerebral palsy.
Comparator representing standard anesthetic technique used during pediatric hip surgery for cerebral palsy.
Primary use
Intended to control pain at the surgical site and decrease the need for postoperative narcotic medication.
Used as standard anesthesia to manage pain during surgery and in the early postsurgical period.
How it is given or performed
Injected locally around the hip joint at the time of surgery, using a mix of anesthetic and anti-inflammatory medications in doses adjusted for patient weight.
Delivered as a lumbar epidural by anesthesia providers during surgery, with ongoing monitoring for safety and pain effectiveness.
Evidence status
Trials in pediatric hip and femoral surgery indicate that local multimodal injections can reduce postoperative opioid consumption and shorten hospital stay in select populations, but more data is needed for cerebral palsy specifically.
Epidural anesthesia is widely accepted for postoperative pain control, but studies suggest it may lead to higher opioid requirements and longer hospital stays compared with certain local injection techniques.
Important limitations
Although local injections may decrease opioid use, robust pediatric cerebral palsy data is limited and rare reactions to anesthetic or additives can occur.
Epidural anesthesia in children with neuromuscular conditions requires careful monitoring because complications such as respiratory depression, urinary retention, or technique failure can occur, and it may not always improve key clinical outcomes compared to newer approaches.
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
Who Can Participate
Age: 0 - 18Years
All Genders
Eligibility Criteria
You may qualify if you...
Under 18 years old
Diagnosis of cerebral palsy or similar neuromuscular disease
Scheduled for uni- or bilateral proximal femoral osteotomy surgery
You will not qualify if you...
Current use of opioid medications before surgery
History of allergic reaction to any component of the pain injection
History of adverse reaction to epidural anesthesia
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Surgery day and immediate postoperative period
Participants receive either a local anesthetic injection or epidural anesthesia during hip surgery to manage pain.
1 surgical visit (in-person)
Post-operative Follow-up
Duration - 2 to 3 weeks post-surgery
Participants are monitored for pain levels, narcotic use, hospital stay length, and parent satisfaction following surgery.
Approximately 3 follow-up visits
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
The effect of a new multimodal perioperative anesthetic regimen on postoperative pain, side effects, rehabilitation, and length of hospital stay after total joint arthroplasty.
Christopher L Peters, Brayton Shirley, Jill Erickson
Fascia Iliaca Pain Block Results in Lower Overall Opioid Usage and Shorter Hospital Stays than Epidural Anesthesia After Hip Reconstruction in Children With Cerebral Palsy.
Dominique Laron, Jennifer Kelley, Vidya Chidambaran...
Reduced hospital stay and narcotic consumption, and improved mobilization with local and intraarticular infiltration after hip arthroplasty: a randomized clinical trial of an intraarticular technique versus epidural infusion in 80 patients.
Karen V Andersen, Mogens Pfeiffer-Jensen, Viggo Haraldsted...