Postoperative Pain, Acute
Conditions
Keywords
TAP, ketorolac, bupivacaine,, ultrasound, children
Brief summary
Control of of pain in children is fundamental. TAP block is associated with less side effects compared with other neuraxial techniques especially when done under ultrasound guidance. Ketorolac has analgesic effect comparable to morphine. Children were arranged randomly into two equal groups, forty-five children in each. Group (K) (n= 45): received ultrasound guided TAP block with bupivacaine 0.25% (0.5 ml/kg) and ketorolac (0.5 mg/kg). Group (T) (n =45): received ultrasound guided TAP block with bupivacaine 0.25% (0.5 ml/kg)
Detailed description
This prospective randomized controlled study were carried out in Sohag university hospitals after getting approval from medical research ethics committee and written informed consents from the patients' parents or legal guardians. This study included 90 ASA status I and II children aged 6-12 years undergoing elective lower abdominal surgeries.Preoperative assessment: * History taking from the parents. * Complete physical examination. * Laboratory investigations: Complete Blood Picture and coagulation profile. Preoperative preparation Before starting, standard monitoring will be as follow: 1. Non-invasive blood pressure (systolic and diastolic). 2. Peripheral Oxygen saturation (SpO2%). After insertion of intravenous line, all children will receive atropine premedication (0.01-0.02 mg/kg). General anesthesia will be induced using propofol 1% (2 mg/kg), atracurium (0.5 mg/kg) to facilitate endotracheal intubation. Anesthesia will be maintained using isoflurane (1-2%) with controlled ventilation.At the end of operation, muscle relaxant is reversed using neostigmine and atropine. Intraoperative hemodynamic parameters will be recorded throughout the surgery at fixed intervals (at time of skin incision then after every 5 min till the end of surgery). Then TAP block were done under ultrasound guidance using either bupivacaine and ketorolac or bupivacaine alone
Interventions
DRUGBupivacain
analgesia
DRUGKetorolac
analgesia
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* ASA status I and II children Age 6-12 years Elective lower abdominal surgeries.
Exclusion criteria
* Parents' or legal guardians' refusal. * A history of developmental delay or mental retardation. * ASA III and IV. * A known allergy to ketorolac or bupivacaine. * Hemodynamic unstable patient * Urgent surgeries
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 1st analgesic requirement | 24 hours | the time at which the 1st need for analgesia is given. |
| Number of patients who requested analgesia | 24 hours | Number (percentage)of patients who requested analgesia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction of the parents regarding their children analgesia | 24 hours | using 5- point satisfaction scale (1= Very satisfied, 2=Satisfied,3= Neither satisfied nor dissatisfied,4= Dissatisfied, 5= Very dissatisfied). This satisfaction will be done by parents according to the VAS, incidence of side effects and analgesic requirements |
| heart rate | 24 hours | the patient vital sign (beats/min) |
| blood pressure | 24 hours | The patients blood pressure (mmHg) |
| Number of children in each group who required analgesia in the first 24 h postoperatively | 24 hours | Number of children in each group who required analgesia in the first 24h postoperatively |
| Total rescue analgesia | 24 hours | Total rescue analgesia in the first 24 h. postoperatively |
Countries
Egypt
Outcome results
None listed