Preemptive Analgesia in Children Using Caudal Epidural Ropivacaine

Loma Linda University (LLU)

Status: Terminated

Conditions: Orchiopexy; Inguinal Herniorrhaphy

Treatments: Drug: Ropivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT00616577

57235

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: 26 patients

Sex: All

Ages: Under 2 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 2 years or younger.
• Weight 33 kg or less.
• Scheduled for elective inguinal herniorrhaphy or orchiopexy.
• American Society of Anesthesiologists Class 1, 2 or 3.

Exclusion criteria

• Age over 2 years.
• Weight over 33 kg.
• Allergy to ropivacaine.
• Usual contraindications to caudal anesthesia (patient refusal, skeletal or spinal cord anomaly, coagulopathy, infection at insertion site, ongoing bacteremia)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Double Blind

---

26 participants in 3 patient groups

Group CB

Experimental group

Description:

Subjects in this arm will receive caudal ropivacaine 0.25% at a dose of 1ml/kg (maximum 15ml) with 1:200,000 epinephrine after induction of general anesthesia prior to surgical incision.

Treatment:

Drug: Ropivacaine

Drug: Ropivacaine

Drug: Ropivacaine

Group CA

Active Comparator group

Description:

Group CA (Caudal After-control group) will receive caudal ropivacaine 0.25% at a dose of 1ml/kg (maximum 15ml) with 1:200,000 epinephrine after completion of surgery but before emergence from anesthesia.

Treatment:

Drug: Ropivacaine

Drug: Ropivacaine

Drug: Ropivacaine

Group LIA

Active Comparator group

Description:

Group LIA (Local Infiltration After-control group) will receive local infiltration of ropivacaine 0.25% up to 1ml/kg (maximum 15ml) around the surgery site at the conclusion of surgery but before emergence from anesthesia.

Treatment:

Drug: Ropivacaine

Drug: Ropivacaine

Drug: Ropivacaine