Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Utilizing Peripheral Nerve Blocks for Pain Management in Pediatric Patients during Embolization and Sclerotherapy for Vascular Malformations

Version 1 : Received: 23 February 2024 / Approved: 23 February 2024 / Online: 23 February 2024 (16:43:01 CET)

A peer-reviewed article of this Preprint also exists.

Kocher, M.; Evankovich, M.; Lavage, D.R.; Yilmaz, S.; Sadhasivam, S.; Visoiu, M. Utilizing Peripheral Nerve Blocks for Pain Management in Pediatric Patients during Embolization and Sclerotherapy for Vascular Malformations. Children 2024, 11, 368. Kocher, M.; Evankovich, M.; Lavage, D.R.; Yilmaz, S.; Sadhasivam, S.; Visoiu, M. Utilizing Peripheral Nerve Blocks for Pain Management in Pediatric Patients during Embolization and Sclerotherapy for Vascular Malformations. Children 2024, 11, 368.

Abstract

Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate to severe pain. This study aims to evaluate the utilization of peripheral nerve blocks in opioid consumption, pain scores, and length of stay. A retrospective chart review was conducted at the UPMC Children's Hospital of Pittsburgh for all patients who underwent embolization and sclerotherapy between 2011 and 2020. Patient data was collected to compare opioid consumption, pain scores, and length of stay. Eight hundred fifty-four procedures were performed on 347 patients. The morphine milligram equivalent per kilogram mean ratio between groups was 0.9 (0.86, 0.95) with a p-value of <0.001. The pain score mean ratio was –1.17 (–2.2, -0.1) and a p-value of 0.027. Length of stay had a mean ratio of 0.94 (0.4, 2) and a p-value of 0.875. By decreasing opioid consumption and postoperative pain scores, peripheral nerve blocks may have utility in patients undergoing embolization and sclerotherapy while not clinically increasing the length of stay for patients. Their use should be individualized and carefully discussed with the interventional radiologist.

Keywords

Peripheral nerve block; Vascular malformation; Embolization therapy; Sclerotherapy; Opioid consumption; Perioperative pain

Subject

Medicine and Pharmacology, Anesthesiology and Pain Medicine

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