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Pain Injection Versus Epidural Anesthesia for Hip Surgery in Pediatric Patients With Cerebral Palsy
Peri-operative Use of a Pain Injection Versus Epidural in Pediatric Patients With Cerebral Palsy
Who can join
Up to age 18 · All sexes
Full eligibility criteria
Inclusion Criteria: * under 18 years old * diagnosis of cerebral palsy or similar neuromuscular disease * undergoing uni- or bilateral proximal femoral osteotomy Exclusion Criteria: * ongoing preoperative opioid use * history of allergic reaction to any component of the pain injection * history of adverse reaction to epidural anesthesia
About the study
Pain management in pediatric patients presents a difficult challenge. Unlike adults, pediatric patients often cannot communicate their pain management needs clearly. This is especially true in patients with cerebral palsy (CP), who often have concomitant developmental delay, intellectual disability and verbal limitations. Current literature indicates pain as a common experience for children with CP but has been understudied in this population. Moreover, inadequate post-operative pain control can result in negative physiologic and psychological complications and lead to poor surgical outcomes. Currently, perioperative pain management following orthopaedic procedures in pediatric patients follows traditional protocols that rely on the administration of opioid medications despite their known adverse side effects including nausea, vomiting, itching, constipation, urinary retention, confusion, and respiratory depression.
Epidural anesthesia is a key modality in traditional pain management for pediatric patients with CP given its proven efficacy in decreasing pain and managing spasticity. Yet, administering epidural anesthesia in this patient population poses several risks including damage to preexisting intrathecal baclofen pumps, iatrogenic infection, and technically demanding insertion given high rates of concomitant neuromuscular scoliosis. Alternatively, multimodal analgesic injections theoretically offer an efficacious adjunct to traditional pain management protocols with a lower risk profile. Preliminary data from our study group's pilot randomized control trial comparing the safety and efficacy of a multimodal surgical site injection to placebo showed decreased pain scores and narcotic consumption postoperatively in this patient population. Based on these promising results, the objective of this randomized control trial is to evaluate the efficacy of a multimodal surgical site injection compared to epidural anesthesia for postoperative pain control following operative management of hip dysplasia in pediatric patients with CP.
What is being tested
- Ropivacaine injection (drug)
- Bupivacaine, lidocaine, ropivacaine (drug)
Sponsor: University of California, Los Angeles · Participants: 90 · Started: Dec 1, 2023
Contact the study team
- Rachel M Thompson, MD · Phone: 213-742-1369
- Nicole J Hung, MD · Phone: 310-592-5180
Official record on ClinicalTrials.gov — NCT06189781
Locations in the U.S.
Conditions
From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.