Educational Problems
Conditions
Keywords
biplane ultrasound, Caudal epidural anesthesia, single plane ultrasound
Brief summary
Ultrasound guidance plays a pivotal role in caudal epidural block in pediatric patients. In comparison to conventional single-plane ultrasound, biplane ultrasound offers the advantage of providing simultaneous transverse and longitudinal imaging. Better visualization under biplane ultrasound is postulated to enhance the efficacy of caudal epidural blocks. This improvement is expected to manifest through higher first puncture success rate, shorter procedure time, and longer time to first postoperative analgesics use.
Detailed description
Our study aims to recruit pediatric patients receiving caudal epidural blocks as a complement to general anesthesia and for postoperative analgesia. Through a randomized allocation, we will administer the caudal injection with either a biplane ultrasound-guided approach or the single-plane ultrasound-guided technique. The assessment will encompass accuracy metrics, such as the first puncture success rate and number of needle redirections, and the efficiency indicators, including the time from initial probe placement on the skin to successful injection, the time to first postoperative analgesics use, and PACU (post anesthesia care unit) pain score. Safety evaluation will be conducted, encompassing adverse events from the commencement of the caudal block procedure until discharge. We will also conduct post-discharge follow-up phone calls to evaluate patients' experience after discharge.
Interventions
OTHERBiplane Ultrasound
During a standard of care caudal epidural block, biplane ultrasound will be used.
OTHERSingle plane ultrasound
During a standard of care caudal epidural block, single plane ultrasound will be used.
Sponsors
University of Florida
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Masking description
The intervention group will receive caudal epidural block under the guidance of biplane ultrasound. The procedures for patients in the control group will be guided by conventional single-plane ultrasound.
Intervention model description
This is a prospective, randomized, parallel study to assess the efficacy of biplane ultrasound-guided caudal epidural anesthesia in pediatric patients.
Eligibility
Sex/Gender
MALE
Age
4 Months to 10 Years
Healthy volunteers
No
Inclusion criteria
* ASA I/II (Anesthesia Physical Status Classification System) * Male patients aged 4 months to 10 years * To undergo elective circumcision with caudal epidural anesthesia as an adjuvant to general anesthesia and for postoperative analgesia
Exclusion criteria
* Anatomical anomalies (e.g., tethered cord, sacral malformations, etc.). * Potential coagulopathy. * Preoperative analgesics use. * Allergy to local anesthetics. * Rash or infection at the injection site. * Female patients * Parents refuse to participate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| First puncture success | 1 day | The epidural is obtained on first attempt. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Needle redirections | 1day | Redirection was defined as pulling the needle back and changing the direction without exiting the skin. |
| Duration of epidural | 1 day | Duration from placing the US probe on skin to successful injection (continuous outcome, measured in second). |
| Postoperative analgesic use | 24 hours post-op | The time from arriving at PACU to first postoperative analgesics use within 24 hours after discharge (continuous outcome, measured in hour). |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORSonia Mehta, MS
University of Florida
Outcome results
None listed