3 Clinical Trials for Various Conditions
Context: Single shot peripheral nerve blocks have limited duration of action depending on the local anesthetic agent used in the block. But it rarely lasts longer than 12 hrs. Patients need oral analgesics at home once the block wears off to control the pain. Objectives: Primary Objective To determine if peripheral nerve blocks have any advantage in terms of decreasing oral analgesic requirements in the post operative period even after the effects of the block have worn off Secondary Objective To determine if inclusion of single shot regional technique improves patient/family satisfaction with post operative pain management . Study Design: Prospective randomized single blinded study. Inclusion Criteria * Children aged between 6 yr and 17yr scheduled for ambulatory peripheral orthopedic surgery with moderate to severe postoperative pain. * Surgery of moderate duration (\<2hr) * Surgery associated with minimal blood loss or fluid shifts (\<10% total blood volume) * American Society of Anesthesiologists (ASA) classification 1 or 2 * Parents able to understand follow up instructions and are able to reach at home by phone Exclusion Criteria * Known allergy to local anesthetics * Preexisting neuropathy with sensory or motor deficits * Skin infection at site of needle placement * Parents refusal for peripheral nerve blocks
Pain is a common cause for children seeking care in the Emergency Department (ED). Children with orthopedic injuries often require pain control when seeking emergency care. Despite the high prevalence of ED visits requiring pain control, pain is often poorly assessed and treated in ED settings. Currently, no standard of care exists for the management of this fracture-related pain in children discharged from the ED. Furthermore, discrepancies in analgesia administration to patients of various racial groups seeking emergency care have been documented but are poorly understood. No research currently exists comparing pain severity between upper extremity fractures requiring simple splinting to those treated with sedated reduction and splinting. Furthermore, there is no research regarding the prevalence of significant post-discharge pain nor the differences among ethnic and age groups treated in the ED. Research Questions: What is the prevalence of significant post-discharge pain in children treated for upper extremity fractures? Is there a difference in severity between those children requiring reduction versus simple splinting? Is there a difference in pain severity noted among different ethnic or age groups? Design This is a prospective, un-blinded, observational study that will include patients seeking treatment for an upper extremity fracture.
Pain is common in children presenting to the emergency department but is frequently undertreated, leading to both short- and long-term consequences. Morphine is the standard treatment for children with moderate to severe acute pain, but its use is associated with serious side effects and caregiver and clinician concerns related to opioid administration. The investigators aim to determine if sub-dissociative ketamine is non-inferior to morphine for treating acute pain and a preferable alternative for treating acute pain in children because of its more favorable side effect profile and potential long-term benefits related to pain-related function, analgesic use/misuse, and mental and behavioral health outcomes.