Tianyi Gao, Zhuorun Song, Shunyi Lu, Nan Song, Wentao Yu, Huilin Yang, Jun Zou, Qian Wang, Jun Ge
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Secondary outcomes included FLACC scale measured at 1 h, 6 h and 24 h postoperatively. They also included postoperative thumb and shoulder strength, opioid use, NSAIDs use, length of hospital stays, patient satisfaction, surgeon satisfaction, operation time and puncture channels. One hundred and five patients were randomized allocated between groups.</p><p><strong>Results: </strong>Patients receiving Cora-MNB showed superior analgesia, with median postoperative FLACC pain scores at 12 h reduced by 40% [Cora-MNB: 3.00 (2.00) vs. SC-BPB: 5.00 (2.00), ***<i>p</i> < 0.001]. Thumb extensor weakness incidence decreased significantly (Cora-MNB: 13.5% vs. SC-BPB: 84.9%, ***<i>p</i> < 0.001). Shoulder mobility preservation was achieved in 98.08% of Cora-MNB cases vs. 20.75% with SC-BPB (***<i>p</i> < 0.001). While opioid consumption showed no intergroup difference, Cora-MNB reduced NSAID rescue times [Cora-MNB: 0.00 (1.00) vs. SC-BPB: 1.00 (1.00), **<i>p</i> = 0.0014]. Procedure duration favored Cora-MNB [4.54 ± 1.21 (min) vs. 9.02 ± 1.94 (min), T = 14.32, 95% CI: 3.88-5.12, ***<i>p</i> < 0.001], with higher surgical and parental satisfaction scores. Hospital stays remained comparable [1.60 ± 0.66 (days) vs. 1.56 ± 0.67 (days), <i>p</i> = 0.98].</p><p><strong>Conclusion: </strong>Cora-MNB proves to be a safe and effective approach for anesthesia in pediatric SHF cases, offering superior analgesic outcomes, reduced NSAIDs usage, improved shoulder functionality, and high satisfaction levels without extending the hospital stay. This study supports the implementation of Cora-MNB as a valuable technique in perioperative pain management for pediatric SHF patients.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1485277"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058737/pdf/","citationCount":"0","resultStr":"{\"title\":\"Ultrasound-guided coracobrachialis plane musculocutaneous nerve block for perioperative analgesia in pediatric Gartland type III supracondylar humerus fracture: a prospective pilot study.\",\"authors\":\"Tianyi Gao, Zhuorun Song, Shunyi Lu, Nan Song, Wentao Yu, Huilin Yang, Jun Zou, Qian Wang, Jun Ge\",\"doi\":\"10.3389/fped.2025.1485277\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Perioperative pain management in children with Gartland Type III supracondylar humerus fractures (SHF) is crucial but often inadequately addressed, leading to significant pain experiences. This study aimed to evaluate the efficacy and safety of coracobrachialis plane musculocutaneous nerve block (Cora-MNB) compared to supraclavicular brachial plexus block (SC-BPB) for analgesia in pediatric Gartland Type III SHF patients.</p><p><strong>Methods: </strong>A prospective pilot study enrolled 105 pediatric patients with Gartland Type III SHF was performed. Primary outcome was the postoperative FLACC scale measured at 12 h postoperatively. Secondary outcomes included FLACC scale measured at 1 h, 6 h and 24 h postoperatively. They also included postoperative thumb and shoulder strength, opioid use, NSAIDs use, length of hospital stays, patient satisfaction, surgeon satisfaction, operation time and puncture channels. One hundred and five patients were randomized allocated between groups.</p><p><strong>Results: </strong>Patients receiving Cora-MNB showed superior analgesia, with median postoperative FLACC pain scores at 12 h reduced by 40% [Cora-MNB: 3.00 (2.00) vs. SC-BPB: 5.00 (2.00), ***<i>p</i> < 0.001]. Thumb extensor weakness incidence decreased significantly (Cora-MNB: 13.5% vs. SC-BPB: 84.9%, ***<i>p</i> < 0.001). Shoulder mobility preservation was achieved in 98.08% of Cora-MNB cases vs. 20.75% with SC-BPB (***<i>p</i> < 0.001). While opioid consumption showed no intergroup difference, Cora-MNB reduced NSAID rescue times [Cora-MNB: 0.00 (1.00) vs. SC-BPB: 1.00 (1.00), **<i>p</i> = 0.0014]. Procedure duration favored Cora-MNB [4.54 ± 1.21 (min) vs. 9.02 ± 1.94 (min), T = 14.32, 95% CI: 3.88-5.12, ***<i>p</i> < 0.001], with higher surgical and parental satisfaction scores. Hospital stays remained comparable [1.60 ± 0.66 (days) vs. 1.56 ± 0.67 (days), <i>p</i> = 0.98].</p><p><strong>Conclusion: </strong>Cora-MNB proves to be a safe and effective approach for anesthesia in pediatric SHF cases, offering superior analgesic outcomes, reduced NSAIDs usage, improved shoulder functionality, and high satisfaction levels without extending the hospital stay. This study supports the implementation of Cora-MNB as a valuable technique in perioperative pain management for pediatric SHF patients.</p>\",\"PeriodicalId\":12637,\"journal\":{\"name\":\"Frontiers in Pediatrics\",\"volume\":\"13 \",\"pages\":\"1485277\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-04-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058737/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fped.2025.1485277\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2025.1485277","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：Gartland III型肱骨髁上骨折（SHF）患儿围手术期疼痛管理至关重要，但往往处理不当，导致明显的疼痛经历。本研究旨在评价喙臂肌平面肌皮神经阻滞(coracobrachialis plane肌皮神经阻滞（Cora-MNB）与锁骨上臂丛神经阻滞（SC-BPB）在小儿Gartland III型SHF患者镇痛中的疗效和安全性。方法：前瞻性先导研究纳入105例Gartland III型SHF患儿。主要预后指标为术后12小时FLACC评分。次要结果包括术后1 h、6 h和24 h的FLACC量表。它们还包括术后拇指和肩部力量、阿片类药物使用、非甾体抗炎药使用、住院时间、患者满意度、外科医生满意度、手术时间和穿刺通道。105名患者被随机分配到两组之间。结果：接受Cora-MNB治疗的患者镇痛效果较好，术后12 h FLACC疼痛评分中位数降低40% [Cora-MNB: 3.00 (2.00) vs SC-BPB: 5.00 (2.00), ***p p p p = 0.0014]。过程持续时间青睐Cora-MNB[4.54±1.21(分钟)和9.02±1.94 (min), T = 14.32, 95%置信区间CI: 3.88 - -5.12, * * * p p = 0.98)。结论：Cora-MNB被证明是一种安全有效的小儿SHF麻醉方法，具有优越的镇痛效果，减少非甾体抗炎药的使用，改善肩部功能和高满意度，且不延长住院时间。本研究支持Cora-MNB作为儿科SHF患者围手术期疼痛管理的一项有价值的技术。
Ultrasound-guided coracobrachialis plane musculocutaneous nerve block for perioperative analgesia in pediatric Gartland type III supracondylar humerus fracture: a prospective pilot study.
Purpose: Perioperative pain management in children with Gartland Type III supracondylar humerus fractures (SHF) is crucial but often inadequately addressed, leading to significant pain experiences. This study aimed to evaluate the efficacy and safety of coracobrachialis plane musculocutaneous nerve block (Cora-MNB) compared to supraclavicular brachial plexus block (SC-BPB) for analgesia in pediatric Gartland Type III SHF patients.
Methods: A prospective pilot study enrolled 105 pediatric patients with Gartland Type III SHF was performed. Primary outcome was the postoperative FLACC scale measured at 12 h postoperatively. Secondary outcomes included FLACC scale measured at 1 h, 6 h and 24 h postoperatively. They also included postoperative thumb and shoulder strength, opioid use, NSAIDs use, length of hospital stays, patient satisfaction, surgeon satisfaction, operation time and puncture channels. One hundred and five patients were randomized allocated between groups.
Results: Patients receiving Cora-MNB showed superior analgesia, with median postoperative FLACC pain scores at 12 h reduced by 40% [Cora-MNB: 3.00 (2.00) vs. SC-BPB: 5.00 (2.00), ***p < 0.001]. Thumb extensor weakness incidence decreased significantly (Cora-MNB: 13.5% vs. SC-BPB: 84.9%, ***p < 0.001). Shoulder mobility preservation was achieved in 98.08% of Cora-MNB cases vs. 20.75% with SC-BPB (***p < 0.001). While opioid consumption showed no intergroup difference, Cora-MNB reduced NSAID rescue times [Cora-MNB: 0.00 (1.00) vs. SC-BPB: 1.00 (1.00), **p = 0.0014]. Procedure duration favored Cora-MNB [4.54 ± 1.21 (min) vs. 9.02 ± 1.94 (min), T = 14.32, 95% CI: 3.88-5.12, ***p < 0.001], with higher surgical and parental satisfaction scores. Hospital stays remained comparable [1.60 ± 0.66 (days) vs. 1.56 ± 0.67 (days), p = 0.98].
Conclusion: Cora-MNB proves to be a safe and effective approach for anesthesia in pediatric SHF cases, offering superior analgesic outcomes, reduced NSAIDs usage, improved shoulder functionality, and high satisfaction levels without extending the hospital stay. This study supports the implementation of Cora-MNB as a valuable technique in perioperative pain management for pediatric SHF patients.
期刊介绍：
Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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