Percutaneous Internal Ring Suturing, Pain Management
Conditions
Keywords
Percutaneous internal ring suturing, Rectus sheath block, Caudal epidural block
Brief summary
Inguinal hernia is one of the most common surgical pathologies in children, and the minimally invasive percutaneous internal ring suturing (PIRS) technique is widely preferred. By providing effective pain control, nerve blocks reduce postoperative opioid requirements, thereby minimising opioid-related adverse effects and lowering the risk of pulmonary and cardiovascular complications. This study aims to compare the postoperative analgesic effects of rectus sheath block and caudal epidural block in pediatric patients undergoing PIRS.
Interventions
PROCEDURERectus Sheath Block
A total volume of 0.5 mL/kg of 0.25% bupivacaine-distributed equally between both sides-will be injected bilaterally under direct ultrasound guidance.
PROCEDURECaudal Epidural Block
A 22G caudal epidural needle will be inserted at approximately a 45° angle toward the sacral hiatus, and the characteristic click sensation will be felt upon passing the sacrococcygeal ligament. The needle will then be advanced carefully in the cephalad direction, parallel to the longitudinal axis of the spinal canal. After confirming correct placement by negative aspiration, 1 mL/kg of 0.25% bupivacaine will be administered.
Sponsors
Diskapi Yildirim Beyazit Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
1 Years to 8 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged between 1 and 8 years * ASA physical status I-II * Patients who underwent PIRS surgery in the operating room and received either a rectus sheath block or a caudal epidural block
Exclusion criteria
* Patients younger than 1 year or older than 8 years * ASA physical status ≥ III * History of bleeding diathesis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Scores | On the operation day | Pain will be assessed at rest and during coughing using the FLACC (Face, Legs, Activity, Cry, Consolability) scale, scored from 0 to 10. Pain assessments will be performed at the 0th, 1st, 2nd, 4th, 12th, and 24th hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative nausea and vomiting | On the operation day | The occurrence of postoperative nausea and vomiting (PONV) and the number of episodes will be recorded. |
| Time to first mobilization | On the operation day | Time to first mobilization will be recorded in hours after surgery. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactElif Şule Özdemir Sezgi
Backup ContactAslı Dönmez
Outcome results
None listed