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Ultrasound-Guided Femoral Nerve Block for Pain Control in an Infant With a Femur Fracture Due to Nonaccidental Trauma

Frenkel, Oron MS, MD*; Mansour, Karim MD; Fischer, Jason W.J. MD, MSc

doi: 10.1097/PEC.0b013e3182447ea3
ED Techniques & Technology

A 3-month-old infant girl was transferred to our emergency department (ED) with a subtrochanteric femoral neck fracture due to nonaccidental trauma. She received multiple doses of parenteral analgesics both before arrival and in our ED. We performed an ultrasound-guided femoral nerve block using 2.0 mL of 0.25% bupivicaine (approximately 1.25 mg/kg) before placing the patient in a Pavlik harness. Successful pain control was achieved within 15 minutes of the procedure allowing pain-free manipulation of the affected extremity. The patient required only a single dose of parenteral narcotics during the ensuing 18 hours. To our knowledge, this is the first report of an ultrasound-guided femoral nerve block used in the ED for pain control in a pediatric patient.

From the *Department of Emergency Medicine, Alameda County Medical Center; †Department of Pediatric Emergency Medicine, Children’s Hospital and Research Center Oakland, Oakland, CA; and ‡Division of Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.

Disclosure: The authors declare no conflict of interest.

Reprints: Oron Frenkel, MS, MD, Department of Emergency Medicine, Alameda County Medical Center, 1411 E 31st St, Oakland, CA 94602 (e-mail: oron.frenkel@gmail.com).

© 2012 Lippincott Williams & Wilkins, Inc.