None listed
Conditions
Brief summary
Rectus sheath block is a valuable regional technique for abdominal wall midline analgesia. It can be used for variety of surgical procedures such as midline laparotomy, umbilical and paraumbilical hernia repair, and laparoscopic surgery. Not all operating theatres, especially in low income countries, are equipped with ultrasound scanners for carrying out US guided regional blocks. In cases of total absence of objective control, neurostimulator guided technique of RSB can be useful. Objective of the study was to check the feasibility of performing neurostimulator guided rectus sheath block. Neurostimulator guided RSB was performed on patients who underwent umbilical or paraumbilical hernia surgery. After performing the block ultrasound scanning of block area and clinical efficacy assessment was performed. Optimal spread of local anaesthetic was achieved in 86 cases (74.14%), and suboptimal spread – in 30 cases (25.86%) of neurostimulator guided rectus sheath blocks. There were no cases of non-optimal local anaesthetic spread. In all cases neurostimulator guided rectus sheath block had high clinical efficacy (there was no motor response to incision and no need for fentanyl administration). We conclude that rectus sheath block can be performed under neurostimulator guidance. Neurostimulator guided rectus sheath block resulted in optimal or suboptimal local anaesthetic spread. Clinical efficacy of neurostimulator guided rectus sheath block was high. Sample size was 58 patients. Neurostimulator guided rectus sheath block was performed bilaterally to each of them. So there were 116 rectus sheath blocks performed. Of them there were 86 optimal and 30 suboptimal spread of local anesthetic.
Interventions
After induction of general anesthesia we performed neurostimulator guided bilateral rectus sheath block in 58 children (average age 34.5 months, body mass 16.4 kg) with ultrasound assessment of block area after doing the blockade in order to chek if local anesthetic have spread properly.
Materials: Ultrasound scanner SonoSite Titan; SonoSite Inc., Washington, USA; Neurostimulator Stimuplex HNS 12, B.Braun, Melsungen, Germany; Insulated needle Stimuplex A, 21G, 50 mm, B.Braun, Melsungen, Germany
After induction of general anesthesia we performed neurostimulator guided bilateral rectus sheath block in 58 children (average age 34.5 months, body mass 16.4 kg) with ultrasound assessment of block area after doing the blockade in order to chek if local anesthetic have spread properly. Materials: Ultrasound scanner SonoSite Titan; SonoSite Inc., Washington, USA; Neurostimulator Stimuplex HNS 12, B.Braun, Melsungen, Germany; Insulated needle Stimuplex A, 21G, 50 mm, B.Braun, Melsungen, Germany Drugs: Bupivacaine 0.25% 0.3 ml/kg for each side. Operator: Pediatric anesthesiologist with at least 10 years experience in pediatric anesthesia and 5 years experience in regional anesthesia. The number of times: Once. The location: Operating theatre in teaching hospital.
Sponsors
Andrew Albokrinov
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
1 Years to 15 Years
Healthy volunteers
No
Inclusion criteria
elective umbilical or paraumbilical hernia surgery, 1-2 ASA physical status
Exclusion criteria
Urgent surgery, >2 ASA physical status, lack of parental consent
Outcome results
None listed