Comparing Analgesic Effects of Caudal and Erector Spinae Plane Blocks in Pediatrics Undergoing Upper Abdominal Surgery

Istanbul University

Status: Completed

Conditions: Anesthesia, Local

Treatments: Drug: Bupivacaine 0.7 ml/kg; Drug: Bupivacaine 0.5 ml/kg

Study type: Interventional

Funder types: Other

Identifiers

NCT04204343

2018/1073

Details and patient eligibility

About

Upper abdominal surgeries are painful and pediatric patients who undergo these operations require effective postoperative pain control. Epidural and caudal blocks are considered to be the gold standard regional analgesia techniques. Currently, ultrasound guidance is commonly used for caudal block performances to demonstrate the cannula placement and the deposition of local anesthetic. Additionally, erector spinae plane block can be a safer alternative for blocking the similar dermatomes. In this study, the aim is to compare postoperative analgesic effects of these two ultrasound-guided techniques in pediatric patients. The primary outcome of this study is the follow-up of FLACC/VAS pain scores. Secondary outcomes are time to first analgesic requirement, number of patients who require rescue analgesic, possible side effects, time to first mobilization, length of hospital stay and chronic pain due to incision after 2 months.

Full description

Upper abdominal surgeries are painful and pediatric patients who undergo these operations require effective postoperative pain control. Blockade of dermatomes between T6 and L1 commonly provides effective postoperative analgesia. Epidural and caudal blocks are considered to be the gold standard regional analgesia techniques as they provide both somatic and visceral analgesia. Currently, ultrasound guidance is commonly used for caudal block performances to demonstrate the cannula placement and the deposition of local anesthetic. Additionally, erector spinae plane block can be a safer alternative for blocking the similar dermatomes. In the present study, the aim is to compare postoperative analgesic effects of these two ultrasound-guided techniques in pediatric patients undergoing upper abdominal surgery. The primary outcome of this study is the follow-up of FLACC/VAS pain scores. Secondary outcomes are time to first analgesic requirement, number of patients who require rescue analgesic, possible side effects (nausea, vomiting, itching, urinary retention, bradycardia, hypotension, respiratory depression), time to first mobilization, length of hospital stay and chronic pain due to incision after 2 months.

Enrollment: 60 patients

Sex: All

Ages: 1 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• undergoing upper abdominal surgery
• ASA(American Society of Anesthesiology)1-2

Exclusion criteria

• denial of patient or parents
• infection on the local anesthetic application area
• infection in the central nervous system
• coagulopathy
• brain tumors
• known allergy against local anesthetics
• anatomical difficulties
• with preexisting cardiac dysfunction
• with history of renal and/or hepatic dysfunction

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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60 participants in 2 patient groups

Caudal Block

Active Comparator group

Description:

US-guided caudal block with 0.7 ml/kg 0.25% Bupivacaine

Treatment:

Drug: Bupivacaine 0.7 ml/kg

Erector Spinae Plane Block

Active Comparator group

Description:

US-guided erector spinae plane block with 0.5 ml/kg 0.25% Bupivacaine

Treatment:

Drug: Bupivacaine 0.5 ml/kg