[Microvascular bone transplantation in a child. Pain therapy with combined nerve blocks].

Apart from the perioperative care in children undergoing microvascular bone transplantation, postoperative pain therapy plays an important role in avoiding the development of chronic pain. Additionally perfusion of the transplant can possibly be improved by sympathicolysis provided by a continuous peripheral nerve block. We report the case of a 7-year-old boy with neurofibromatosis type I who underwent an autologous fibula transplantation due to an aplastic left radius. The perioperative pain management was performed via a preoperatively placed axillary plexus catheter combined with a proximal sciatic nerve catheter. Via both catheters a continuous postoperative infusion of 0.1% ropivacaine (3 ml/h) was performed. Within the first 5 postoperative days complete pain relief at rest could be achieved.