Peripheral Nerve Blocks in Pediatric Orthopedic Patients

Context: Single shot peripheral nerve blocks have limited duration of action depending on the local anesthetic agent used in the block. But it rarely lasts longer than 12 hrs. Patients need oral analgesics at home once the block wears off to control the pain. Objectives: Primary Objective To determine if peripheral nerve blocks have any advantage in terms of decreasing oral analgesic requirements in the post operative period even after the effects of the block have worn off Secondary Objective To determine if inclusion of single shot regional technique improves patient/family satisfaction with post operative pain management . Study Design: Prospective randomized single blinded study. Inclusion Criteria * Children aged between 6 yr and 17yr scheduled for ambulatory peripheral orthopedic surgery with moderate to severe postoperative pain. * Surgery of moderate duration (\<2hr) * Surgery associated with minimal blood loss or fluid shifts (\<10% total blood volume) * American Society of Anesthesiologists (ASA) classification 1 or 2 * Parents able to understand follow up instructions and are able to reach at home by phone Exclusion Criteria * Known allergy to local anesthetics * Preexisting neuropathy with sensory or motor deficits * Skin infection at site of needle placement * Parents refusal for peripheral nerve blocks