Abstract: Objective To evaluate the effect of a multimodal intervention on children undergoing developmental dislocation of hip (DDH) orthopedic surgery. Methods One hundred and twenty American Society of Anesthesiologists (ASA) Ⅰ or Ⅱ children aged 2−5 y, body mass 12−21 kg, scheduled for DDH orthopedic operation were allocated into 4 groups (n=30) according to random number table method, preoperative education and nerve block group (PN group), preoperative education and analgesia group (PA group), block and analgesia group (NA group), preoperative education, nerve block and analgesia group (PNA group). The children in PN, PA, and PNA groups were given animated videos during a preoperative visit to teach them the operation and anesthesia process. Subsequently, the children in PN, NA, PNA groups were treated with ultrasound‑guided lateral femoral cutaneous nerve block after induction of general anesthesia. After the operation, children in PA, NA, PNA groups were given parent‑controlled intravenous analgesia. Heart rate, mean arterial blood pressure (MAP) and modified Yale Preoperative Anxiety Scale (mYPAS) scores were recorded at the preoperative visit (T0), entering the operating room (T1), induction of general anesthesia (T2), 12 h after the operation (T3), 24 h after the operation (T4) and 48 h after the operation (T3). The score of Induction Compliance Checklist (ICC) was also recorded at T2. The Visual Analogue Scale (VAS) scores and the dosage of fentanyl were measured and recorded at 0.5 h (T'0), 2 h (T'1), 12 h (T'2), 24 h (T'3), 48 h (T'4). The complications of shivering, nausea and vomiting, respiratory depression, and bleeding were observed and recorded. Results There was no significant difference in age, sex ratio, body mass, anesthesia time, operation time, and bleeding volume among the four groups (P>0.05). Compared with the NA group, the heart rate, MAP and mYPAS scores of the PN, PA and PNA groups were significantly low (P<0.05) at T1, T2, T3 and T4. Heart rate and MAP at T5 were also appreciably low (P<0.05). Compared with PNA group, the heart rate, MAP and mYPAS scores of PNA and PA groups at T3 and T4 were significantly high (P<0.05). During anesthesia induction, compared with the NA group, the ICC scores of PN, PA, and PNA groups had low scores (P<0.05). Compared with the PA group, the VAS scores of PN, NA, and PNA groups at T'0, T'1, T'2, T'3, and T'4 were significantly low (P<0.05). While compared with PN groups, the VAS scores of NA and PNA were significantly low at these five time points (P<0.05). During the intraoperative period, compared with the PA group, the fentanyl dosage of PN, NA, PNA groups was low (P<0.05). No obvious complications occurred in all groups. Conclusions Preoperative education and multimodal analgesia intervention can relieve anxiety and tension in children undergoing DDH orthopedic surgery. It can also reduce the VAS scores and fentanyl usage during the perioperative period.
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