Ultrasound guidance plays a pivotal role in caudal epidural block in pediatric patients. In comparison to conventional single-plane ultrasound, biplane ultrasound offers the advantage of providing simultaneous transverse and longitudinal imaging. Better visualization under biplane ultrasound is postulated to enhance the efficacy of caudal epidural blocks. This improvement is expected to manifest through higher first puncture success rate, shorter procedure time, and longer time to first postoperative analgesics use.
Our study aims to recruit pediatric patients receiving caudal epidural blocks as a complement to general anesthesia and for postoperative analgesia. Through a randomized allocation, we will administer the caudal injection with either a biplane ultrasound-guided approach or the single-plane ultrasound-guided technique. The assessment will encompass accuracy metrics, such as the first puncture success rate and number of needle redirections, and the efficiency indicators, including the time from initial probe placement on the skin to successful injection, the time to first postoperative analgesics use, and PACU pain score. Safety evaluation will be conducted, encompassing adverse events from the commencement of the caudal block procedure until discharge. We will also conduct post-discharge follow-up phone calls to evaluate patients' experience after discharge.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
281
During a standard of care caudal epidural block, biplane ultrasound will be used.
During a standard of care caudal epidural block, single plane ultrasound will be used.
UF Health
Gainesville, Florida, United States
First puncture success
The epidural is obtained on first attempt.
Time frame: 1 day
Number of Needle redirections
Redirection was defined as pulling the needle back and changing the direction without exiting the skin.
Time frame: 1day
Duration of epidural
Duration from placing the US probe on skin to successful injection (continuous outcome, measured in second).
Time frame: 1 day
Postoperative analgesic use
The time from arriving at PACU to first postoperative analgesics use within 24 hours after discharge (continuous outcome, measured in hour).
Time frame: 24 hours post-op
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