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Ultrasound-guided FICB for Proximal Femoral Osteotomy in Pediatric Patients

Not Applicable
Recruiting
Conditions
Orthopedic Disorder
Interventions
Procedure: Control
Procedure: Ultrasound-guided fascia iliaca compartment block
Registration Number
NCT04570891
Lead Sponsor
Seoul National University Hospital
Brief Summary

This prospective randomized controlled trial aims to examine the effect of fascia iliaca compartment block on the postoperative pain and opioid consumption in pediatric patients (3y≤ age \<18y) who will undergo orthopedics surgery (proximal femoral osteotomy).

Patients will be allocated to either the FICB(Fascia iliaca compartment block + IV PCA) group or the control group (no block + IV PCA). Fascia iliaca compartment block will be performed using 0.25% ropivacaine (1mL/kg, MAX 30mL) under ultrasound-guidance at the end of surgery.

The total opioid consumption at 12, and 24 hours after the surgery, and the pain score at 10 min after PACU admin, 1,6,24 hours after the surgery, the total dose of additional rescue analgesia (intravenous ketorolac or nalbuphine) at 12 and 24 hours after the surgery will be recorded.

Detailed Description

This prospective randomized controlled trial aims to examine the effect of fascia iliaca compartment block on postoperative pain and opioid consumption in pediatric patients (3y≤ age \<18y) who will undergo orthopedics surgery (proximal femoral osteotomy).

Patients will be allocated to either the FICB(Fascia iliaca compartment block + IV PCA) group or the control group (no block + IV PCA). Fascia iliaca compartment block will be performed using 0.25% ropivacaine (1mL/kg, MAX 30mL) under ultrasound-guidance at the end of surgery.

The total opioid consumption at 12, and 24 hours after the surgery, and the pain score at 10 min after PACU admin, 1,6,24 hours after the surgery, the total dose of additional rescue analgesia (intravenous ketorolac or nalbuphine) at 12 and 24 hours after the surgery will be recorded.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
36
Inclusion Criteria
  • 36 children aged between 3 and 18 years who undergo proximal femoral osteotomy
Exclusion Criteria
  • Complex surgery (other than proximal femoral osteotomy)
  • Allergy to opioid
  • Allergy to local anesthetics
  • Disease in heart, lung, kidney, and liver
  • Coagulation disorder
  • Disease in the central and peripheral nervous system
  • Unstable vital sign
  • Significant renal impairment (Creatinine> 3.0 mg/dl)
  • Significant hepatic impairment (aspartate transaminase> 120 unit/L, alanine aminotransferase> 120 unit/L)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ControlControlNo regional block is provided at the end of surgery.
FICBUltrasound-guided fascia iliaca compartment blockUltrasound-guided fascia iliaca compartment block (0.25% ropivacaine 1mL/kg, Max 30mL) will be provided at the end of surgery.
Primary Outcome Measures
NameTimeMethod
total opioid consumption at 12 hours after the end of surgeryat 12 hours after the end of surgery

total opioid consumption at 12 hours after the end of surgery (IV Nalbuphine 1mg = IV Morphine 1mg = IV Fentanyl 10mcg (0.01mg) per kilogram of body weight.

Secondary Outcome Measures
NameTimeMethod
total opioid consumption at 24 hours after the end of surgeryat 24 hours after the end of surgery

total opioid consumption at 24 hours after the end of surgery (IV Nalbuphine 1mg = IV Morphine 1mg = IV Fentanyl 10mcg (0.01mg) per kilogram of body weight.

Numeric rating scale10 minutes after the PACU admin, 1hour, 6hours, and 24hours after the end of surgery.

by Numeric rating scale: A numerical rating scale (NRS) requires the patient to rate their pain on a defined scale. For example, 0-10 where 0 is no pain and 10 is the worst pain imaginable.

Total additional dose of ketorolacat 12hours, and 24hours after the end of surgery.

Total additional dose of ketorolac (mg) per kilogram of body weight.

pupil constriction velocity (CV)at 1 hour after the end of surgery

measured by pupillometer

Total additional dose of nalbuphineat 12hours, and 24hours after the end of surgery.

Total additional dose of nalbuphine (mg) per kilogram of body weight.

Hospital staywithin 14 days after the end of surgery

Hospital stay (days)

Neurological Pupil indexTM (NPi)at 1 hour after the end of surgery

measured by pupillometer

Intact toe sensory at the second postoperative day (POD-2)At the second postoperative day (POD-2)

Intact toe sensory at the second postoperative day (POD-2)

Wong-Baker Faces Pain Rating Scaleat 10 minutes after the PACU admin, 1hour, 6hours, and 24hours after the end of surgery.

by Wong-Baker Faces Pain Rating Scale: There are 6 faces in the Wong-Baker Pain Scale. The first face represents a pain score of 0, and indicates "no hurt". The second face represents a pain score of 2, and indicates "hurts a little bit." The third face represents a pain score of 4, and indicates "hurts a little more". The fourth face represents a pain score of 6, and indicates "hurts even more". The fifth face represents a pain score of 8, and indicates "hurts a whole lot"; the sixth face represents a pain score of 10, and indicates "hurts worst".

The incidence of side effects of analgesic medicationswithin 24 hours after the end of surgery

Nausea, Vomit, Constipation, Pruritus, Dizziness, Dry mouth, Sedation

Normal capillary refill time (< 3 seconds) at the second postoperative day (POD-2)At the second postoperative day (POD-2)

Normal capillary refill time (\< 3 seconds) at the second postoperative day (POD-2)

The incidence of side effects of ropivacainewithin 1 hour after the end of surgery

Arrhythmia, Hypotension, ST change, Dizziness, Convulsion

Extensor hallucis longus function (motor power of extension of the big toe: I-V) at the second postoperative day (POD-2)At the second postoperative day (POD-2)

Extensor hallucis longus function (motor power of extension of the big toe: I-V) at the second postoperative day (POD-2)

Trial Locations

Locations (1)

Jin-Tae Kim

🇰🇷

Seoul, Korea, Republic of

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