Ultrasound Guided Transversus Abdominis Plane Block Versus External Oblique Intercostal Plane Block for Postoperative Analgesia in Pediatrics Undergoing Open Nephrectomy
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Transversus Abdominis Plane Block
- Sponsor
- Tanta University
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Time to the 1st rescue analgesia
- Status
- Completed
- Last Updated
- 5 months ago
Overview
Brief Summary
The aim of this study is to compare the ultrasound guided TAP Block and EOIP block for postoperative analgesia in pediatrics undergoing open nephrectomy.
Detailed Description
Nephrectomy in children may also be for malignant conditions of the kidney and adrenal glands. The major indications for nephrectomy vary in different parts of the world and in different age groups and sexes with some recording more benign conditions and others more of malignancies Ultrasound-guided transversus abdominis plane (TAP) block is a relatively new technique to infiltrate regional anesthesia in which local routine anesthetics are injected between the internal oblique and transverse abdominal muscles. The purpose is to provide analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall. External oblique intercostal plane block (EOIPB) has been reported by Elsharkawy et al. in 2021 as a significant modification of fascial plane blocks in that it may engage the upper lateral abdominal walls consistently. In comparison to quadratus lumborum block (QLB) and erector spinae plane block (ESPB) , The advantage of EOIPB is that it may be performed with the patient supine. Furthermore, in comparison to serratus intercostal plane block (SIPB), it generates more extensive analgesic effects throughout the whole midline of the abdomen .
Investigators
Mohammed Said ElSharkawy
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tanta University
Eligibility Criteria
Inclusion Criteria
- •Age ≤ 18 years.
- •Both sexes.
- •American Society of Anesthesiology (ASA) physical status I-III.
- •Scheduled for open nephrectomy.
Exclusion Criteria
- •Abnormal blood coagulation.
- •Scar, infection, and tumor of puncture site.
- •History or family history of high malignant fever.
- •Severe cardiovascular problems.
Outcomes
Primary Outcomes
Time to the 1st rescue analgesia
Time Frame: 24 hours postoperatively
A standardized analgesic regimen will be prescribed in the post-operative period. All patients will receive paracetamol 15 mg /kg/8 hrs as routine analgesia. Rescue analgesia of morphine will be given as 0.05 mg/kg if face, legs, activity, and cry consolability scale (FLACC) ≥ 4 and the maximum allowed dose is 0.1mg/kg every 4 hours. FLACC will be assessed at 0, 2, 4, 8, 12 and 24h postoperatively. it will be measured from the end of surgery to first dose of morphine administrated.
Secondary Outcomes
- Intraoperative fentanyl consumption(Intraoperatively)
- Degree of pain(24 hours postoperatively)
- Total morphine consumption(24 hours postoperatively)
- Mean arterial pressure(Every 15 minutes till the end of surgery)