Analgesia in Children Using Caudal Epidural Ropivacaine

Loma Linda University (LLU)

Status: Completed

Conditions: Circumcision; Inguinal Hernia

Study type: Observational

Funder types: Other

Identifiers

NCT01494272

5110235

Details and patient eligibility

About

Caudal epidural analgesia (caudal block)is used in standard pediatric anesthesia practice. It has been shown to be effective in managing postoperative pain in children undergoing abdominal and infraumbilical surgery (Tobias et al 1994). Furthermore, studies have shown that children receiving caudal blocks have secondary benefits such as lower narcotic and anesthetic requirements, more rapid awakening from general anesthesia, decreased time to discharge home, and fewer pain-related behaviors postoperatively (Conroy et al 1993, Tobias et al 1995, Tobias 1996).

This proposed study involves the use of a caudal block in children undergoing elective inguinal herniorrhaphy or orchiopexy to evaluate the role of preemptive analgesia in pediatric pain management. We hypothesize that by inhibiting peripheral pain receptors with a caudal block before the onset of a painful stimulus, we can decrease central nervous system sensitization and reduce postoperative analgesic requirements

Enrollment: 90 patients

Sex: All

Ages: 2 months to 2 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Age 2 months to 2 years
2. Weight 25kg or less
3. ASA class 1, 2, 3
4. Elective inguinal herniorrhaphy or orchiopexy

Exclusion criteria

1. Contraindications to caudal epidural analgesia
2. parent's refusal
3. skeletal or spinal cord anomaly
4. coagulopathy
5. infection at the insertion site
6. ongoing bacteremia
7. allergy to ropivacaine

Trial design

90 participants in 3 patient groups

Group CB (Caudal Before-study group)

Description:

This group will receive caudal ropivacaine and epinephrine after induction of general anesthesia prior to surgical incision

Caudal After (CA)-control group

Description:

This group will receive caudal ropivacaine with epinephrine after completion of surgery but before emergence from anesthesia

Local Infiltration After (LIA) control group

Description:

This group will receive local infiltration of ropivacaine around the surgery site at the conclusion of surgery but before emergence from anesthesia