Arteriovenous Fistula, Opioid Sparing, Pediatric, Supraclavicular Brachial Plexus Block
Conditions
Brief summary
This study aims to evaluate the efficacy of supraclavicular brachial plexus block as an opioid-sparing technique in pediatric patients undergoing arteriovenous fistula creation.
Detailed description
The global incidence of end-stage renal failure (ESRF) is increasing. The preferred procedure for patients with ESRF undergoing maintenance Haemodialysis (HD) is the placement of an arteriovenous fistula (AVF). In patients with ESRF, brachial plexus block (BPB) is frequently employed to administer anesthesia for the establishment or modification of AVF. This technique offers pain relief, sympathetic blockade, ideal surgical conditions, and a sufficient duration of postoperative block, preventing arterial spasms and graft thrombosis
Interventions
OTHERSupraclavicular brachial plexus block
Patients will receive an ultrasound-guided supraclavicular brachial plexus block.
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 I- III. * Undergoing arteriovenous fistula creation under general anesthesia.
Exclusion criteria
* Allergy to local anesthetics. * Infection at the site of block. * Local infection. * Coagulation disorder. * Previously failed or revision of blocked arteriovenous fistula.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Intraoperative fentanyl consumption | Intraoperatively |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total opioid consumption | 24 hours postoperatively | Rescue analgesia of 0.5 µg/kg fentanyl will be given if the Wong-Baker score is 4 more. |
| 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 fentanyl administrated) will be assessed. |
| Degree of pain | 24 hours postoperatively | Degree of pain will be assessed using Wong-Baker score (0 to 10), 0= no hurt and 10= hurts worst. Wong-Baker score will be assessed at post-anesthesia care unit (PACU), 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, PONV, respiratory depression, or any other complication will be recorded. |
Countries
Egypt
Outcome results
None listed