Ultrasound-Guided Lumbar Erector Spinae Plane Block Versus Caudal Block for Postoperative Analgesia in Hip and Proximal Femur Surgery in Pediatric Patients

Cairo University76 enrolled

Overview

The study will compare Ultrasound-Guided Lumbar Erector Spinae Plane Block and caudal block for Postoperative Analgesia in Hip and Proximal Femur Surgery in pediatric patients

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Post Operative Pain

Interventions

erector spinea blockPROCEDURE

the patients will receive a single injection erector spinea block after induction of general anesthesia

Caudal epidural blockPROCEDURE

the patients will receive caudal epidural block after induction of general anesthesia

Eligibility

Sex: ALLMin age: 1 YearMax age: 7 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA I-II. * Scheduled to undergo hip or proximal femur surgeries. Exclusion Criteria: * Refusal of participation by parents or caregivers * Known local anesthetic (LA) drug sensitivity * Bleeding disorders with INR \> 1.5 and/or platelets \< 100,000/mm3. * Skin lesions or wounds at the site of proposed needle insertion.

Locations (1)

Kasr Alaini hospital

Cairo, Egypt

Outcomes

Primary Outcomes

Pain score

By using face, legs, activity, and cry consolability scale \[FLACC \] FLACC scale will be measured as following: Each category (face,legs,activity, and cry consolability) is scored on the 0-2 scale which results in a total score of 0-10. Assessment of the final score: 0 = Relaxed and comfortable 1-3 = Mild discomfort 4-6 = Moderate pain 7-10 = Severe discomfort/pain

Time frame: 2 hours post-operatively

Secondary Outcomes

pain scores

Time frame: at 2 hour intervals during the first 24 hours postoperatively

Block failure rate

The block will be considered a failed block if the patient required more than two doses of rescue analgesia in the first hour postoperatively

Time frame: First hour postoperatively

Block performance time

Time frame: Preoperative

The incidence of adverse effects

Time frame: Up to one week after the block

Duration of the block

Time frame: UP to 48 hours postoperatively

Degree of contralateral motor blockage and lower limb weakness

By using modified bromage scale as following: Grade I : Free movement of legs and feet Degree of block :Nil (0%) Grade II :Just able to flex knees with free movement of feet Degree of block :Partial (33%) Grade III :Unable to flex knees, but with free movement of feet Degree of block: Almost complete (66%) Grade IV :Unable to move legs or feet Degree of block: Complete (100%)

Data from ClinicalTrials.gov

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