Post Operative Pain
Conditions
Brief summary
The study will compare Ultrasound-Guided Lumbar Erector Spinae Plane Block and caudal block for Postoperative Analgesia in Hip and Proximal Femur Surgery in pediatric patients
Interventions
PROCEDUREerector spinea block
the patients will receive a single injection erector spinea block after induction of general anesthesia
PROCEDURECaudal epidural block
the patients will receive caudal epidural block after induction of general anesthesia
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
1 Years to 7 Years
Healthy volunteers
No
Inclusion criteria
* ASA I-II. * Scheduled to undergo hip or proximal femur surgeries.
Exclusion criteria
* Refusal of participation by parents or caregivers * Known local anesthetic (LA) drug sensitivity * Bleeding disorders with INR \> 1.5 and/or platelets \< 100,000/mm3. * Skin lesions or wounds at the site of proposed needle insertion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain score | 2 hours post-operatively | By using face, legs, activity, and cry consolability scale \[FLACC \] FLACC scale will be measured as following: Each category (face,legs,activity, and cry consolability) is scored on the 0-2 scale which results in a total score of 0-10. Assessment of the final score: 0 = Relaxed and comfortable 1-3 = Mild discomfort 4-6 = Moderate pain 7-10 = Severe discomfort/pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Block failure rate | First hour postoperatively | The block will be considered a failed block if the patient required more than two doses of rescue analgesia in the first hour postoperatively |
| Block performance time | Preoperative | — |
| pain scores | at 2 hour intervals during the first 24 hours postoperatively | By using face, legs, activity, and cry consolability scale \[FLACC \] FLACC scale will be measured as following: Each category (face,legs,activity, and cry consolability) is scored on the 0-2 scale which results in a total score of 0-10. Assessment of the final score: 0 = Relaxed and comfortable 1-3 = Mild discomfort 4-6 = Moderate pain 7-10 = Severe discomfort/pain |
| Duration of the block | UP to 48 hours postoperatively | — |
| Degree of contralateral motor blockage and lower limb weakness | UP to 48 hours postoperatively | By using modified bromage scale as following: Grade I : Free movement of legs and feet Degree of block :Nil (0%) Grade II :Just able to flex knees with free movement of feet Degree of block :Partial (33%) Grade III :Unable to flex knees, but with free movement of feet Degree of block: Almost complete (66%) Grade IV :Unable to move legs or feet Degree of block: Complete (100%) |
| The incidence of adverse effects | Up to one week after the block | — |
Countries
Egypt
Outcome results
None listed