Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children

Study Objective: To determine whether fascia iliaca compartment block (FICB) reduces emergence agitation. Design: Prospective, randomized, blinded clinical trial. Setting: Operating room and Postanesthesia Care Unit (PACU) of a university hospital. Patients: 64 ASA physical status 1 and 2 pediatric patients aged three to 7 years, scheduled for orthopedic surgery involving the anterior or lateral thigh. Interventions: Patients enrolled in the FICB group received FICB immediately after the operation, while control group patients received intravenous (IV) patient/parent-controlled analgesia (PCA) with fentanyl. Measurements: Severity of agitation and pain were evaluated using the Pediatric Agitation and Emergence Delirium (PAED) scale and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). Data were collected at 10-minute intervals in the PACU. The results were analyzed using the t-test. Main Results: PAED scores in the FICB group were significantly lower than those of the control group on arrival at the PACU (7.3 +/- 2.9 vs 10.4 +/- 3.2, P < 0.001). The FICB group also had significantly lower CHEOPS pain scores than the control group, both on arrival at the PACU and 10 minutes after arrival (6.4 +/- 1.5 vs 10.4 +/- 1.8, P < 0.001 and 6.7 +/- 1.6 vs 8.0 +/- 1.4, P = 0.009, respectively). Conclusion: In children having surgery on the thigh, FICB effectively reduced the severity of emergence agitation and postoperative pain during the immediate postoperative period. (C) 2011 Elsevier Inc. All rights reserved.