Post-operative Pain Relief for Paediatric Inguinal-Scrotal Surgery

Dr Kumarvel Veerappan

Status: Unknown

Conditions: Hernia, Inguinal

Treatments: Procedure: Caudal block; Procedure: Nerve Block; Drug: Standarising intraoperative pain relief

Study type: Interventional

Funder types: Other

Identifiers

NCT03167047

16/LO/1187

Details and patient eligibility

About

Two methods of pain control in children undergoing surgery on the groin and scrotum are caudal injection (a form of epidural) with local anaesthetic, and a regional nerve block (an injection of local anaesthetic around the nerves supplying the area). A pilot study at our hospital showed a significant decrease in post-operative pain and nausea and vomiting in these two methods when compared to intravenous morphine and local anaesthetic to the wound.

One potential side effect from caudal injections is temporarily decreased motor power in the legs due to the local anaesthetic - it is thought that this might be overcome using a more dilute solution of local anaesthetic along with clonidine. This study is to demonstrate that this method is as effective as the use of a regional nerve block.

Enrollment: 50 estimated patients

Sex: All

Ages: 1 month to 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children undergoing day case elective inguinal-scrotal surgery

Exclusion criteria

• Contraindication to technique
• Significant comorbidities
• Patient/parent refusal

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

50 participants in 2 patient groups

Caudal block

Active Comparator group

Description:

Caudal epidural given for post-operative pain relief. Dose used is 1.5ml/kg of weak Levo-Bupivacaine solution (0.125%). Patients will also receive standardised pain relief of paracetamol and fentanyl

Treatment:

Procedure: Caudal block

Drug: Standarising intraoperative pain relief

Nerve block

Active Comparator group

Description:

Peripheral nerve block given for post operative pain relief. Levo-Bupivacaine 0.25% 2mg/Kg given under ultrasound guidance. Patients will also receive standardised pain relief of paracetamol and fentanyl

Treatment:

Procedure: Nerve Block

Drug: Standarising intraoperative pain relief