Comparing Analgesic Effects of Three Ultrasound Guided Regional Anesthetic Techniques in Pediatrics
- Registration Number
- NCT03780790
- Lead Sponsor
- Istanbul University
- Brief Summary
This study evaluates analgesic effects of ultrasound-guided (USG) regional anesthetic techniques; caudal block , transversus abdominis plane (TAP) block and quadratus lumborum block (QLB) by comparing postoperative pain scores \[ Face, Legs, Activity, Cry, Consolabilty(FLACC) and Visual Analogue Scale (VAS)\], first analgesic requirement time and total analgesic consumption in pediatrics undergoing lower abdominal surgery. We also aim to observe the side effects of these techniques such as nausea, vomiting, bradycardia, hypotension, respiratory depression.
- Detailed Description
Lower abdominal surgeries affect dermatomes T10-L1 and blocking these nerve roots provides effective postoperative analgesia. Neuroaxial blocks such as epidural and caudal blocks is considered the gold standart regional technique for pain management after lower abdominal surgery, blocking both somatic and visceral pain. Nowadays,US is increasingly used to perform caudal block, demostrating cannule placement and precise deposition of local anesthetic in the epidural space. On the other side truncal blocks as US-guided TAP block covers T10-L1 dermatomes and provides postoperative pain relief after lower abdominal surgery with lower complication rate rather than caudal block but it may not prevent traction on the peritoneal sac. QLB is rather a new regional technique blocking nerve roots close to paravertebral area affecting somatic and visceral nerve fibers. In our study we aim to compare postoperative analgesic effects of these three techniques in paediatrics. Our primary outcomes are pain scores(FLACC/VAS) and first additional analgesic requirement time. Secondary outcomes are total analgesic consumption, side effects (nausea, vomiting, itching, urinary retention, bradycardia, hypotension, respiratory depression), length of hospitalization and chronic pain due to incision after 2 months.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 135
- undergoing lower abdominal surgery
- ASA(American Society of Anestesiology)1-2
- denial of patient or parents,
- infection on the local anesthetic application area
- infection in central nervous system
- coagulopathy
- brain tumours
- known allergy against local anesthetics
- anatomical difficulties
- with preexisting cardiac dysfunction
- with history of renal and/or hepatic dysfunction
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Transversus Abdominis Plane Block Bupivacaine US- guided transversus abdominis plane block will be performed with 0,5 ml/kg 0.25% Bupivacaine into the fascial plane between internal oblique muscle and transversus abdominis muscle Quadratus Lumborum Block Bupivacaine US-guided quadratus lumborum block will be performed with 0,5 ml/kg 0.25% Bupivacaine in the anterior layer of the thoracolumbar fascia between psoas major and quadratus lumborum muscles Caudal Block Bupivacaine US-guided caudal epidural block will be applied to 0.7 ml/kg 0.25 % Bupivacaine up to a maximum of 20 mL
- Primary Outcome Measures
Name Time Method Face, Legs Activity, Cry, Consolability (FLACC) scores up to 48 hours It includes five categories of behavior, each scored on 0-2 point scale so that total score ranges from 0 to 10. Total scores of 0-3 is defined as mild or no pain, 4-7 as moderate, and 8-10 as severe pain.
- Secondary Outcome Measures
Name Time Method Hospital stay Through study completion, an average of 1 week Hospitalisation
First analgesic requirement time Up to 48 hours Duration of postoperative analgesia
Number of patients who require rescue analgesic up to 48 hours Number of patients who require IV tramadol (1 mg/kg) at the first 2 hours and parasetamol in the 48 hours
Trial Locations
- Locations (1)
Istanbul University
🇹🇷Istanbul, Turkey