Analgesia, Pediatric Thoracotomy, Rhomboid Intercostal Block, Sub-Serratus Plane Block, Subtransverse Process Interligamentary Plane Block
Conditions
Brief summary
This study aims to compare ultrasound guided subtransverse process interligamentary plane block versus rhomboid intercostal block combined with sub-serratus plane block for postoperative analgesia in pediatric thoracotomy.
Detailed description
Post-thoracotomy pain is one of the most severe types of pain on the first day of the surgery. In pediatric patients, inadequate analgesia may lead to adverse circulatory and respiratory compromise. The subtransverse process interligamentary (STIL) plane block is a recently introduced technique that offers a safer alternative by targeting thoracic nerves without entering the paravertebral space. Recently, some studies have shown that the rhomboid intercostal block (RIB) and the RIB combined with the sub-serratus plane block (RISS) can provide good analgesia effects after video assisted thoracoscope.
Interventions
OTHERStandard intravenous analgesia
Patients will receive no block intervention and standard intravenous analgesia will be given.
OTHERSubtransverse process interligamentary plane block
Patients will receive ipsilateral ultrasound-guided subtransverse process interligamentary (STIL) plane block with bupivacaine 0.25% (0.5 mL/kg) after induction of general anesthesia.
OTHERRhomboid intercostal block (RIB) combined with sub-serratus plan block group
Patients will receive ipsilateral ultrasound-guided rhomboid intercostal block (RIB) combined with sub-serratus plan block group with bupivacaine 0.25% (0.5mL/kg) after induction of general 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 12 Years
Healthy volunteers
No
Inclusion criteria
* Pediatric patients between 6 to 12 years. * Both sexes. * American Society of Anesthesiologists (ASA) Physical Status I - II. * Scheduled for thoracic surgery with thoracotomy incision under general anesthesia.
Exclusion criteria
* Parents who refused regional anesthesia. * Patients were presented with advanced kidney, cardiac or liver diseases. * Coagulation and bleeding disorders. * Patients presented with skin or soft tissue infection at the proposed site of needle Insertion. * Patients with cognitive impairment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to first rescue analgesia | 24 hours postoperatively | Time to the first rescue analgesia will be recorded from the end of surgery till first dose of morphine adminstrated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | Each patient will be instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed after surgery over 24 hours (30 minutes postoperative, 2, 4, 6, 12, 24 hours. |
| Total Opioids consumption | 24 hours postoperatively | Morphine 0.05 mg /kg IV will be given as rescue analgesia if VAS score ≥4, morphine dose will not exceed 0.3 mg/kg/day. |
| Intraoperative fentanyl consumption | Intraoperatively | Fentanyl 0.5 μg/kg will be administrated in the case of inadequate analgesia that defined as an un explained increase of heart rate (HR) and/or mean arterial blood pressure (MAP) more than 20% above the preoperative values after exclusion of other causes. |
Countries
Egypt
Contacts
CONTACTWalaa A Elbialy, MSc
Outcome results
None listed