{
  "abstract": "Background and Aims The aim of this abstract is to present and analyze the effectiveness of lower leg analgesia using ultrasound-guided popliteal nerve block in pediatric patients with ankle fractures in the course of opioid free anesthesia and also to conduct a comparative clinical study compared to classical conventional intravenous analgesia, including opioids.Methods For period of 2 years we followed and compared 108 pediatric patients (7 y-17 y), undergoing surgical treatment of ankle fractures. All patients were ASA I. 35 (32.4%) children underwent ultrasound-guided popliteal nerve block with Lidocaine 1% + Ropivacaine 0.5% = 0.3 ml/kg with sedation (propofol V=2 mg/kg/h) and 78 (67.6%) children received general anesthesia (TIVA with propofol), including opioid analgesia (fentanyl). Intraoperatively analgesia is estimated by hemodynamics (objective criteria) and postoperatively-by hemodynamics (objective criteria) and standard pain scale scores - VAS, BOPS and PADS (subjective criteria).Results In the regional anesthesia group 6 children (17.15%) required single dose of additional intravenous opioid analgesia (fentanyl -.8–0.9 mcgr/kg) and the rest of 82.85% (29 children) were opioid free during the procedure.Abstract EP004 Figure 1Intraoperative analgesiaAbstract EP004 Figure 2Ultrasound image of target structuresAbstract EP004 Figure 3Double doughnut sign-typical for accurate spread of LAConclusions Opioid-sparing and opioid free anesthesia are becoming more and more tempting and desired as being safer and more comfortable both for the patients and the anesthesiologist. Ultrasound-guided regional blocks provides perfect conditions for the above mentioned. Nevertheless, pediatric patients still remain a challenge for performing regional nerve blocks from the perspective of cooperation, understanding and feedback. Our study revealed a safe profile of the ultrasound-guided popliteal nerve block in children with uneventful course, no side effects and prevalence of opioid free anesthesia.",
  "authors": [
    {
      "affiliations": [
        "Pediatric Anesthesia and Intensive Care, UMHATEM N I Pirogov, Sofia, Bulgaria"
      ],
      "name": "Elena Ivanova"
    },
    {
      "affiliations": [
        "Anesthésie, PH(practices hospitalier ) CH Simone Veil, Eaubonne, Paris, France"
      ],
      "name": "Margarita Borislavova"
    }
  ],
  "title": "EP004 The role of ultrasound-guided popliteal nerve block in opioid free anesthesia for ankle fractures in pediatric patients",
  "uid": "5771873f-afce-5941-be58-bb62d5c881c0"
}