Children, Erector Spinae Plane Block, Thoracoscopic Sympathectomy
Conditions
Brief summary
This study aims to evaluate the influence of ultrasound-guided erector spinae plane block on postoperative pain and diaphragmatic dysfunction in pediatric patients undergoing thoracoscopic sympathectomy.
Detailed description
Pain may occur after pediatric thoracic surgery in cases such as skin incision creation, rib traction, and drain placement, and in other cases, such as rib nerve injury. Such pain is highly unfavorable to pediatric patients' recovery as it may lead to reduced cough strength for clearing secretions, decreased functional residual capacity, and pulmonary complications such as atelectasis and pneumonia. Erector spinae plane block (ESPB) is a novel trunk block to relieve chronic neuropathic pain. Since then, it has gained prominence as a regional anesthesia technique with the potential to revolutionize postoperative pain management, and it has been effectively administered not only for the management of perioperative pain for a wide variety of surgeries but also for the management of acute post-traumatic pain and chronic pain.
Interventions
OTHERErector spinae plane block
Patients will receive bilateral erector spinae plane block after the induction of general anesthesia as a study group.
OTHERGeneral anesthesia
Patients will not receive the block after the induction of general anesthesia as a control group.
Sponsors
Menoufia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
* Age from 6 to 16 years. * Either sexes (male or female). * American Society of Anesthesiologists (ASA) physical status I-II. * Scheduled for bilateral thoracoscopic sympathectomy under general anesthesia.
Exclusion criteria
* History of allergy to local anesthetics. * Abnormal liver/kidney function. * Severe spinal deformities. * Bleeding or coagulation disorders. * Skin damage or infection at the proposed puncture site.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | Postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents no pain while 10 represents the worst pain imaginable). NRS will be assessed on arrival at the post-anesthesia care unit (PACU), 1, 2, 4, 8, 12, and 24 h postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diaphragmatic excursion | 24 hours postoperatively | Diaphragmatic excursion will be recorded using ultrasound preoperatively and postoperatively. |
| Total analgesic consumption | 24 hours postoperatively | Total analgesic consumption will be recorded. |
| Anesthetic consumption: minimum alveolar concentration | Intraoperatively | Anesthetic consumption: minimum alveolar concentration (MAC) of sevoflurane every 10 min using Anesthetic Consumption = Flow Rate × Concentration of Anesthetic in Vapor. |
| Incidence of complications | 24 hours postoperatively | Incidence of complications such as local anesthetic systemic toxicity (LAST), bradycardia, hypotension, nausea, vomiting, and respiratory depression will be recorded. |
| Recovery profile | 24 hours postoperatively | Recovery profile will be recorded using Richmond Agitation and Sedation Scale (RASS) was required to be between - 3 and + 4 for a delirium classification (ISMV 4 only; RASS not collected in ISMV 3. |
| Time to the first request for the rescue analgesia | 24 hours postoperatively | Time to the first request for the rescue analgesia will be recorded from the end of surgery till first dose of meperidine administrated. |
Countries
Egypt
Contacts
Primary ContactSafaa M Sallam, Master
Outcome results
None listed