Erector Spinae Plane Block, External Oblique Intercostal Plane Block, Pediatric, Upper Abdominal Surgeries
Conditions
Brief summary
This study aims to compare between ultrasound guided external oblique intercostal plane block and ultrasound guided erector spinae plane block in paediatric upper abdominal surgeries.
Detailed description
Paediatric nerve blocks are increasingly recognized as new standard for managing pain in children. The advantages of regional anesthesia in this population include enhanced operating conditions, expedited recovery of bowel function, and reduced postoperative pain. The caudal epidural block remains the most used method; however, the external oblique intercostal block, a novel technique involves administering local anesthesia deep to the external oblique muscle at the sixth intercostal space, thereby blocking thoracoabdominal nerves from T6 to T10. This technique offers several advantages, including straightforward anatomy, a single muscle strip that is easily identifiable even in obese patients, a bony backstop, and an easily expandable fascial plane that can accommodate a catheter. The erector spinae plane block involves injecting local anesthetic into the fascial plane beneath the erector spinae muscle at the tip of the vertebral transverse process. This allows the local anesthetic to spread in the craniocaudal fascial plane.
Interventions
OTHERExternal oblique intercostal plane block
Patients will receive ultrasound-guided external oblique intercostal plane block.
OTHERErector spinae plane block
Patients will receive ultrasound-guided erector spinae plane block.
Sponsors
Alexandria University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* Children aged between 6 and 12 years of both sex. * Patients with the American Society of Anesthesiologists (ASA) physical status I/II. * Patients undergoing upper abdominal surgeries involving upper abdominal incisions.
Exclusion criteria
* Guardian refusal. * Allergy to local anesthetics. * Surgical procedures exceeding 3 hours. * Infection at the area planned for the block injection. * Prolonged opioid medication. * Patients preoperatively medicated by Beta blockers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 12 hours after surgery | Postoperative pain will be assessed using Faces pain score revised. The Faces Pain Scale revised (FPS-R) is a validated self-report instrument designed to measure pain intensity in pediatric populations. The scale comprises a series of facial expressions, ranging from a smiling face at 0, indicating "no pain," to a crying face at 10, indicating "very much pain". Children are instructed to select the face that most accurately reflects their current pain level. The faces are scored (0, 2, 4, 6, 8, 10), providing a quantifiable measure of pain intensity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | Every 15 minutes intraoperative | Heart rate will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative. |
| Mean arterial blood pressure | Every 15 minutes intraoperative | Mean arterial blood pressure will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative. |
| Peripheral oxygen saturation | Every 15 minutes intraoperative | Peripheral oxygen saturation will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative. |
| Duration of analgesia | 12 hours after surgery | Duration of analgesia will be recorded from block completion till first postoperative rescue analgesia requirement. |
| Total rescue analgesia requirement | 12 hours after surgery | In Faces Pain Scale score-revised, cut of points for analgesic requirement is ≧ 4, rescue analgesia will be administered in the form of nalbuphine 0.1 mg/kg, with a maximum dose of 0.2 mg/kg. |
| Incidence of complications | 12 hours after surgery | Incidence of complications including hematomas block failure, intravascular injection, pneumothorax or injection into the peritoneal cavity, with associated risks of damage to bowel and other abdominal viscera at the block site will be recorded. |
Countries
Egypt
Contacts
CONTACTBelal M Hassan, MBBCH
Outcome results
None listed