Ultrasound Guided Posterior Versus Lateral Transversus Abdominis Plan Block for Prolonged Postoperative Analgesic Effect in Children

Overview

Ultrasound Guided Posterior Versus Lateral Transversus Abdominis Plan Block for Prolonged Postoperative Analgesic Effect in Children

Full Title of Study: “Ultrasound Guided Posterior Versus Lateral Transversus Abdominis Plan Block for Prolonged Postoperative Analgesic Effect in Children . Randomized Controlled Trial”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Health Services Research
    • Masking: None (Open Label)
  • Study Primary Completion Date: November 5, 2019

Detailed Description

the investigators will compare the effect of posterior Transversus abdominis plan block versus the effect of lateral transversus abdominis plan bock regarding the duration of analgesia and patients satisfaction the study will be conducted on 69 children aged from 1 to 7 years presented for lower abdominal surgery.

Interventions

  • Procedure: postoperative analgesia for lower abdominal surgery in children
    • compare lateral and posterior approaches of trannsversus abdominis plane block for analgesia after lower abdominal surgery in children

Arms, Groups and Cohorts

  • Active Comparator: lateral transversus abdominis block
    • patients will take lateral transversus abdominis plan block. The block will be done unilaterally on the same side of proposed surery with 0.25% bupivacaine at a volume of 1 ml·kg-1
  • Active Comparator: posterior tansversus abodominis plane block
    • patients will take posterior transversus abdominis plane block. The block will be done unilaterally on the same side of proposed surery with 0.25% bupivacaine at a volume of 1 ml·kg-1
  • Active Comparator: convential analgesia
    • conventional analgesia in form of 1 micrograms. Kg-1 fentanyl and paracetamol 15 mg. Kg-1 suppositories

Clinical Trial Outcome Measures

Primary Measures

  • postoperative pain assessment by the CHEOPS score
    • Time Frame: the first 24 hours postoperative
    • Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) for Post-Op Pediatric Pain the score is based on 6 crtiteria: crying facial expression child verbal expression body positiion touching or grabbing at wound legs position criterion 1 is given a score of 1-3, criterion 2 and 3 are given score 0-2, criterion 4,5 and 6 are given a score 1-2 making the worst possible score 13 while the least possible score is 4. a total score of 6 or less indicates adequate analgesia

Secondary Measures

  • heart rate
    • Time Frame: at 2,4,8,12 and 24 hours postoperative
    • Measurement of heart rate (beats per minute)
  • Mean arterial blood pressure
    • Time Frame: at 2,4,8,12 and 24 hours postoperative
    • Measurement of Mean arterial blood pressure ( mm Hg)

Participating in This Clinical Trial

Inclusion Criteria

  • children from 1- 7 years – scheduled to undergo lower abdominal surgery Exclusion Criteria:

  • bleeding disorders – emergency surgery – skin lesion at site of needle insertion

Gender Eligibility: All

Minimum Age: 1 Year

Maximum Age: 7 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Kasr El Aini Hospital
  • Provider of Information About this Clinical Study
    • Principal Investigator: Mohamed Maher Kamel, lecture of anesthesia – Kasr El Aini Hospital
  • Overall Contact(s)
    • Mohamed M Kamel, MD, 01005238534, mohamedmaher959@yahoo.com

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