This prospective randomized controlled trial aims to investigate the effect of ultrasound-guided selective supraclavicular nerve block on pain control after Hickman catheter, chemoport, or Perm cath insertion in children.
Pediatric patients undergoing surgical insertion of a Hickman catheter, chemoport, or Permcath are randomly assigned to a test group (Ultrasound-guided selective supraclavicular nerve block with Ropivacaine) and a control group (Nerve block is not performed). Immediately after induction of general anesthesia, in the test group, the supraclavicular nerve block was selectively performed using ultrasound using 0.1mL/kg of 0.5% Ropivacaine (Maximum dose: 5mL), and the nerve block was not completed in the control group. After that, a Hickman catheter, chemoport, or Permcath is surgically inserted in the usual way and allowed to recover from anesthesia. The pain score is evaluated between 10 and 30 minutes of entering the recovery room (1 hour after the procedure) and 1 hour, 3 hours, and 24 hours after leaving the recovery room by another research team who is unaware of the group assignment. In addition, the use of additional analgesic drugs and related side effects were collected before discharge.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
The nerve involved in the operation of Hickman catheter, chemoport, and Perm cath is the supraclavicular nerve. Therefore, it is judged that if only this nerve is selectively blocked, pain control can be effectively performed with a small amount of local anesthetic, and relatively few side effects occur.
No intervention
Jin-Tae Kim
Seoul, South Korea
Pain score
Wong-Baker Faces Pain Rating Scale is used
Time frame: Pain score measured when communication is possible between 10 and 30 minutes after entering the recovery room.
Pain score
Numeric rating scale is also evaluated if communication is possible
Time frame: Pain score measured when communication is possible between 10 and 30 minutes after entering the recovery room.
Pain score
Wong-Baker Faces Pain Rating Scale is used
Time frame: Pain score for 1 hour, 3 hours, and 24 hours after leaving the recovery room
Pain score
Numeric rating scale is also evaluated if communication is possible
Time frame: Pain score for 1 hour, 3 hours, and 24 hours after leaving the recovery room
Additional narcotic analgesics administered
Amount per body weight of additional narcotic analgesics administered.
Time frame: Within 24 hours of the end of surgery
Additionally administered non-narcotic analgesics
Amount per body weight of additionally administered non-narcotic analgesics.
Time frame: Within 24 hours of the end of surgery
Side effects related to pain medication
Nausea, Vomit, Constipation, Pruritus, Dizziness, Dry mouth, Sedation, etc.
Time frame: Within 24 hours of the end of surgery
Complications related to ropivacaine use
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Arrhythmia, Hypotension, ST change, Dizziness, Convulsion, etc.
Time frame: Within 1 hour after procedure
Whether diaphragmatic palsy
It is confirmed by chest X-ray taken in the operating room. Diaphragmatic palsy can usually be suspected on chest X-rays showing abnormal hemidiaphragm elevation. Therefore, we will check the chest X-ray for abnormal hemidiaphragm elevation.
Time frame: Within 24 hours of the end of surgery
Whether diaphragmatic palsy
It is confirmed by lung ultrasound in the recovery room. Hemidiaphragm visualization by ultrasound is achieved from an anterior approach, with the patient in a supine position. At the ultrasound, the diaphragm appears as a thick echogenic line. M-mode US may be used to measure the direction of diaphragmatic motion and the amplitude of excursion. The two indexes usually used for the diagnosis of diaphragmatic paralysis include a Tdi value \<2 mm and a diaphragm thickening fraction (TFdi)value \<20% \[Tdi: The thickening of the diaphragm, TFdi: (thickness at the end of the inspiration - thickness at the end of expiration)/thickness at the end of expiration (in %)\].
Time frame: Within 24 hours of the end of surgery
Hospital stay
The period from discharge from recovery room to discharge
Time frame: No more than one month
Check the blockage
The quality of the selective supraclavicular nerve block will be tested with loss of cold sensation using an alcohol swab.
Time frame: When communication is possible between 10 and 30 minutes after entering the recovery room.