Elsey NM, et al. - This prospective, randomized, double-blinded study aimed to evaluate the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. In the pediatric population, the physicians failed to describe a clear benefit of regional anesthesia over intravenous opioids intraoperatively and postoperatively during repair of femoral shaft fractures.

• The study criteria was fulfilled by 17 pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture.
• The physicians randomly assigned them to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7).
• During the surgical repair of the femur fracture, all patients received a general anesthetic with isoflurane for maintenance anesthesia.
• Patients in the FN-LFCN block group received ultrasound-guided nerve blockade using ropivacaine (0.2%/0.5% based on patient weight).
• They removed the airway device once tracheal extubation criteria were achieved at the conclusion of surgery.
• Patients were transported to the post-anesthesia care unit (PACU) for recovery and assessment of pain by a blinded study nurse.

• The physicians enrolled 17 patients in the final study cohort (n = 10 for FN-LFCN block group; n = 7 for the intravenous opioid group).
• Despite the fact that the median of the maximum postoperative pain scores in the regional group was 0, this did not reach statistical significance when compared to the median pain score of 3 in the intravenous opioid group.
• Similarly, they found no difference between the 2 groups when comparing intraoperative anesthetic requirements, opioid requirements (intraoperative, in the post-anesthesia recovery room, and in the inpatient ward), and the time to first opioid requirement postoperatively in the inpatient ward.