Circumcision, Lower Abdominal Surgery
Conditions
Keywords
Ultrasound, Pain, Caudal block, Erector spinae block
Brief summary
Caudal block (CB), a regional anesthesia technique, is the most commonly used neuraxial block method for postoperative pain control in sub-umbilical surgeries in children. However, peripheral nerve blocks have been reported to be preferred in recent years in the literature since they provide longer and safer analgesia. One of these blocks, the erector spina plane (ESP) block, has been shown to provide effective postoperative analgesia when administered from the lumbar level for sacral and lower abdominal surgeries and urogenital surgeries in pediatric patients.
Detailed description
Circumcision and any lower abdominal surgery in the pediatric population result in a very painful postoperative period, even when each procedure is evaluated separately. Caudal block (CB), a regional anesthesia technique, is the most commonly used neuraxial block method for postoperative pain control in sub-umbilical surgeries in children. However, peripheral nerve blocks have been reported to be preferred in recent years in the literature since they provide longer and safer analgesia. One of these blocks, the erector spina plane (ESP) block, has been shown to provide effective postoperative analgesia when administered from the lumbar level for sacral and lower abdominal surgeries and urogenital surgeries in pediatric patients. As far as we know, there is no previous study in the literature comparing CB and ESP block in pediatric patients.
Interventions
PROCEDURERegional anesthesia intervention
Ultrasound-guided caudal and erector spinae blocks were administered
Sponsors
Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
1 Years to 7 Years
Healthy volunteers
Yes
Inclusion criteria
* 1-7 years of age * ASA (American Society of Anesthesiologists) I-II group * Scheduled for circumcision and unilateral lower abdominal surgery at the same session * Able to communicate in Turkish * Willing to participate to the study (parents and children)
Exclusion criteria
* Less than 1 or more than 7 years of age * A neurological deficit, bleeding diathesis, or a history of local anesthetic allergy; an infection or redness in the injection area, congenital lumbar anomaly, liver and/or kidney disorder, a psychiatric disorder, mental retardation, or communication problems detected during examination * Unwilling to to participate to the study ((parents or children)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Level of Postoperative pain | Up to 24 hours | It was assessed seven times after the operation with Face, Legs, Activity, Cry, Consolability (FLACC) scale. The lowest scale score is 0 points and the highest 10 points. Following transfer from the recovery unit to the ward, the 1st, 2nd, 4th, 6th, 12th and 24th hour pain levels were evaluated by the ward nurse. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time of Postoperative analgesic requirement | Up to 24 hours | It was assessed seven times after the operation with Face, Legs, Activity, Cry, Consolability (FLACC) scale. The lowest scale score is 0 points and the highest 10 points. Significant pain behavior for the scale has been identified as 4 points or more. Following transfer from the recovery unit to the ward, the 1st, 2nd, 6th, 12th and 24th hour pain levels were evaluated by the ward nurse. Paracetamol was administered IV at a dose of 10 mg/kg if the scale score was 4 or higher. |
| Rate of Postoperative complications | Up to 24 hours | Urinary retention, hematoma, ecchymosis, motor block were postoperative complications. They were assessed by an anesthesiologist. |
Countries
Turkey (Türkiye)
Outcome results
None listed