Ultrasound Guided Sacral Erector Spinae Plane Block in Pediatric Anorectal Surgery
- Conditions
- Analgesia
- Interventions
- Registration Number
- NCT04921007
- Lead Sponsor
- Sameh Fathy
- Brief Summary
This study will be conducted to evaluate efficacy of ultrasound guided sacral erector spinae plane block for postoperative analgesia in pediatric anorectal surgery in comparison to caudal block.
- Detailed Description
Regional anesthesia in children has become increasingly popular over the past few decades. A variety of peripheral and central nerve blocks have been developed to ensure that perioperative pain can be effectively controlled. So, it possible to reduce the dose concentrations of systemic drugs and improved hemodynamic stability in high-risk patients. Erector spinae plane (ESP) block with various approaches been used in many surgeries and obtained great popularity despite of its novelty. After first description; lower thoracic, lumbar and sacral approaches were defined for postoperative analgesia. There are a few cases in which sacral ESP block was administered and reported.
The aim of this study is to compare postoperative analgesic effect of ultrasound guided sacral ESP block and caudal block. It is hypothesized that sacral ESP block will be comparable to caudal block as a promising effective alternative for analgesia in patients who will undergo pediatric anorectal surgery with fewer side effects.
This prospective, randomized, comparative clinical study will include 60 children who will be scheduled for elective anorectal surgery under general anesthesia in Mansoura university hospitals. Informed written consent will be obtained from parents of all subjects in the study after ensuring confidentiality. The study protocol will be explained to parents of all patients in the study who will be kept fasting prior to surgery. Patients will be randomly assigned to two equal groups (ESP and caudal) according to computer-generated table of random numbers using the permuted block randomization method. The collected data will be coded, processed, and analyzed using SPSS program. All data will be considered statistically significant if P value is ≤ 0.05.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
- American Society of Anesthesiology (ASA) I and II patients.
- Scheduled for pediatric anorectal surgery
- Parental refusal of consent.
- Children with developmental delays, mental or neurological disorders.
- Bleeding or coagulation diathesis.
- History of known sensitivity to the used anesthetics.
- Infection or redness at the injection site.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Group (B) Caudal block Caudal block Ultrasound guided caudal block will be performed in the lateral position under sterile conditions, and bupivacaine will be administered. Group (A) Sacral ESP block Sacral ESP block Ultrasound guided sacral erector spinae plane (ESP) block will be performed in the lateral position under sterile conditions, and bupivacaine will be administered. Group (B) Caudal block Bupivacaine Hydrochloride Ultrasound guided caudal block will be performed in the lateral position under sterile conditions, and bupivacaine will be administered. Group (A) Sacral ESP block Bupivacaine Hydrochloride Ultrasound guided sacral erector spinae plane (ESP) block will be performed in the lateral position under sterile conditions, and bupivacaine will be administered.
- Primary Outcome Measures
Name Time Method Duration for the first analgesic request Up to 24 hours after the procedure The time of the first analgesic request for paracetamol in minutes will be recorded.
- Secondary Outcome Measures
Name Time Method Changes in heart rate Up to end of the surgery Heart rate (beat/min) is recorded at ten-minute intervals until the end of the surgery.
Changes in mean arterial blood pressure Up to end of the surgery Blood pressure (mmHg) is recorded at ten-minute intervals until the end of the surgery.
Value of parent satisfaction from the procedure Up to 24 hours after the procedure The parents will be investigated postoperatively for the quality of the procedure verbally (0-10; 0=None, 10=total satisfaction)
Total analgesic requirements of paracetamol Up to 24 hours after the procedure The amount of paracetamol consumption in milligrams given as a rescue analgesia
Improvement in pain scores Up to 24 hours after the procedure Pain score from 0 to 10 (0 = no pain and 10 = the worst imaginable pain) is assessed postoperatively at 1, 2, 4, 8, 12, 24 hours
Changes in postoperative emergence agitation scale Up to 30 minutes after the procedure Agitation is assessed using the 5- step Cravero scale (1-5) every five minutes from awakening and for 30 minutes.(1:Obtunded with no response to stimulation, 2:Asleep but responsive to movement or stimulation, 3:Awake and responsive, 4:Crying, 5:Thrashing behaviour that requires restraint)
Trial Locations
- Locations (1)
Department of Anesthesia, Mansoura University Hospitals
🇪🇬Mansoura, Dakahlia, Egypt