Erector Spinae Plane Block, Opioid, Pediatric, Selective Dorsal Rhizotomy, Sparing, Spastic Cerebral Palsy
Conditions
Brief summary
This study aims to evaluate the efficacy of bilateral erector spinae plane block as an opioid-sparing technique for selective dorsal rhizotomy in pediatric patients with spastic cerebral palsy.
Detailed description
Cerebral palsy (CP) is the most common physical disability affecting children. Selective dorsal rhizotomy (SDR) is a neurosurgical procedure that permanently reduces lower limb spasticity in children with CP by selectively targeting and removing sensory rootlets with aberrant activity. Postoperative pain is often distressing for patients and their families and can result in complications, delayed participation in therapy, and poor functional recovery. Erector spinae plane block (ESPB) is a newly described interfascial plane block. ESPB is effective on both visceral and somatic pain.
Interventions
OTHERErector Spinae Plane Block
Patients will receive erector spinae plane block after induction of anesthesia.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Age from 6 to 18 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status II, III. * Patients with spastic cerebral palsy undergoing selective dorsal rhizotomy.
Exclusion criteria
* Allergy to local anesthetics. * Severe fixed joint deformity. * Previous orthopedic surgery. * Patient with abnormal liver/kidney function. * Patient with skin damage or infection at the proposed puncture site.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | 24 hours postoperatively | Rescue analgesia of 0.05 mg/kg morphine will be given if the Wong-Baker score is 4 more to be repeated after 30 min if pain persists until the Wong-Baker score \< 4. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to the 1st rescue analgesia | 24 hours postoperatively | Time to the first request for the rescue analgesia (time from end of surgery to the first dose of morphine administrated) will be assessed. |
| Degree of pain | 24 hours postoperatively | Each patient will be instructed about postoperative pain assessment with the Wong-Baker pain rating scale (The scale contains a series of six faces ranging from a happy face at 0 to indicate no hurt to a crying face at 10 to indicate hurts worst). Wong-Baker score will be assessed at post anesthesia care unit, 4, 6, 8, 12, 18 and 24 h postoperatively. |
| Patient satisfaction | 24 hours postoperatively | Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied) |
| Incidence of adverse events | 24 hours postoperatively | Incidence of adverse events such as Local anesthetic systemic toxicity (LAST), bradycardia, hypotension, postoperative nausea and vomiting (PONV), respiratory depression, or any other complication will be recorded. |
Countries
Egypt
Outcome results
None listed