Continuous Femoral Nerve Blockade for Analgesia in Children with Femoral Fractures

paediatric Femoral nerve block is established as a simple and effective method of acute pain control in adults and children with femoral fractures.When bupivacaine is used the block lasts for sufficient time to allow painless manipulation of the fracture and application of traction.However, pain often persists for several days after fracture reduction in children.Pain arises from the femoral periosteum and is exacerbated by movement at the fracture site and reflex muscle spasm in quadriceps femoris causing further fracture movement.I Internal fixation of the femur is not usually performed in children.Smaller children may be managed at home after application of a plaster hip spica to immobilise the fracture.Most children presenting to this hospital are managed with a prolonged period of traction.Minor manipulation of the fracture is often required in the first few days, causing further pain.A simple technique to provide continuous femoral nerve blockade was therefore devised.This has become the standard method of pain relief for children with femoral fractures at this institution.