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Effect of Nerve Block Under Ultrasound on Postoperative Prognosis in Children

Not Applicable
Completed
Conditions
Quality of Recovery
Interventions
Procedure: Ultrasound-guided lower abdominis rectus sheath block
Procedure: Local anesthesia infiltration
Registration Number
NCT05820503
Lead Sponsor
Affiliated Hospital of Nantong University
Brief Summary

The goal of this study was to compare the incidence of pain and recovery agitation after single-port laparoscopic inguinal hernia repair in children. The main questions it aims to answer are:

* Reduction of postoperative pain by rectus sheath block compared with local anesthesia infiltration and control group

* A comparison between rectus sheath block and local anesthesia infiltration and control group on the reduction of agitation during postoperative recovery If there is a comparison group: The researchers will compare the ultrasound-guided rectus sheath group with the local anesthesia infiltration group and the control group to look at postoperative pain indicators and the incidence of waking agitation.

Detailed Description

Postoperative emergence delirium is a common phenomenon in clinical practice, with an incidence rate of up to 20% to 80%. It has long been a concern and research topic in the medical community. In recent years, with the continuous improvement and updating of anesthesia technology, research on pediatric emergence delirium has become more and more in-depth.

The goal of this study was to compare the incidence of pain and recovery agitation after single-port laparoscopic inguinal hernia repair in children. The main questions it aims to answer are:

* Reduction of postoperative pain by rectus sheath block compared with local anesthesia infiltration and control group

* A comparison between rectus sheath block and local anesthesia infiltration and control group on the reduction of agitation during postoperative recovery If there is a comparison group: The researchers will compare the ultrasound-guided rectus sheath group with the local anesthesia infiltration group and the control group to look at postoperative pain indicators and the incidence of waking agitation.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
112
Inclusion Criteria
  • Age: 5~12 years old Male and female Single hole inguinal hernia repair surgery should be performed Parents volunteered to participate in the study and signed an informed consent
Exclusion Criteria
  • Preexisting neuropathy Coagulopathy Local skin infection Hepatic, renal, or cardiorespiratory failure Local anesthetic allergy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
R group :Ultrasound-guided lower abdominis rectus sheath block groupUltrasound-guided lower abdominis rectus sheath blockUnder ultrasound guidance, the probe was transversely placed at the lateral level of the umbilicus . Using the in-plane technique, the needle was advanced until the posterior aspect of the rectus muscle was penetrated. No blood and no gas were drawn back; furthermore, a small volume of saline was initially injected to ensure that the needle tip was correctly positioned. When the needle was located between the posterior rectus muscle and posterior sheath, 5ml of 0.25% ropivacaine was injected bilaterally.
Local anesthesia infiltration GroupLocal anesthesia infiltrationLocal anesthesia drugs were injected into the peri-umbilicus cord
Primary Outcome Measures
NameTimeMethod
Face Legs Activity Cry Consolability (FLACC) score0,2, 4, 6, 12, 24, 36, and 48 hours postoperatively

The Face Legs Activity Cry Consolability (FLACC) scale method is an effective method mainly used for postoperative pain assessment in children . It includes 5 contents: Face, Legs, Activity, Cry and Consolability. Each item is scored on a scale of 0 to 2, with the highest total score being 10. Using the FLACC scale method, doctors need to observe children for 1 to 15 minutes. The pain score is obtained by the medical staff according to the observed children's situation and the content in the quantification table. The total score is obtained by adding up the scores of each content, ranging from 0 to 10. The higher the score, the higher the pain. Doctors can observe children during routine checkups. Touch and change the child's position to determine the child's pain and better assess its body tension and resistance.

Pediatric Anesthesia Emergence Delirium (PAED) scaleAssessments were performed 5 minutes and 10 minutes after awakening, and the highest score was taken

The PAED scale is a reliable tool for assessing postoperative delirium in children, including 5 scoring items, namely eye contact with caregivers, purposeful activities, cognition of the surrounding environment, and the uneasiness and comfort of children. Each evaluation item can be divided into levels 1 to 5 according to the degree, with 0 to 4 points respectively, and the maximum total score is 20 points. A score of ≥10 on the PAED scale indicates the presence of postoperative delirium, and a score of ≥15 indicates the presence of severe postoperative delirium

Secondary Outcome Measures
NameTimeMethod
Cumulative use of anesthetic drugs during surgeryPerioperative period

The cumulative use of remifentanil and propofol during the operation.

Trial Locations

Locations (1)

Affiliated Hospital of Nantong University

🇨🇳

Nantong, Jiangsu, China

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