The goal of this prospective study is to is to evaluate the perioperative pain management of Erector Spinae Block versus Caudal Block using the Face, Legs, Activity, Cry, Conceal ability (FLACC) Pain Scale inn children aged 2 to 7 years old. The main question it aims to answer is: Which block is more efficient in the perioperative period? Participants will be evaluated intraoperative and postoperative for hemodynamic changes and their pain will evaluated according to the FLACC score.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
60
Ultrasound Guided Erector Spinae Plane block given bilaterally at level of L1.
Ukltrasound Guided Caudal Epidural Block
El Shatby University Hospital for Children
Alexandria, EL Shatby, Egypt
Compare the efficacy of postoperative pain management of Erector Spinae Block versus Caudal Block.
Evaluate postoperative pain using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. A score of 0 = no pain, 10 = severe pain. A score ≥4 requires rescue analgesia.
Time frame: At 15 minutes and 30 minutes in PACU, then every 2 hours up to 8 hours after surgery.
Changes to heart rate (beats/minute)
Changes to heart rate (beats/minute) recorded before surgery, during surgery and immediately after surgery
Time frame: T0: before induction of anesthesia T1: after induction of anesthesia (within 5 minutes) T2: immediately after block placement (within 5 minutes) T3: start of surgery T4: every 10 minutes intraoperative until the end of surgery T5: end of surgery
The time to first rescue analgesic.
Time from block administration to the patient's first requirement for rescue analgesia.
Time frame: from 0 to 8 hours after block administration
Total postoperative analgesic requirements.
Amount and frequency of analgesia patient requested
Time frame: from 0 to 8 hours after block administration
Parent satisfaction with a 5-point Likert scale questionnaire.
Parent or caregiver satisfaction about block efficiency on a scale of 1 to 5.
Time frame: At 8 hours after block administration
Number of patients required rescue analgesic postoperatively.
Number of patiebts of asked for rescue analgesia is recorded.
Time frame: From 0 to 8 hours after surgery.
Time to Modified Aldrete score ≥9.
Postoperative recovery was assessed using the Modified Aldrete Scoring System, which evaluates five physiological criteria: activity, respiration, circulation, consciousness, and oxygen saturation
Time frame: from arrival to PACU (0 hours) until achieving an Aldrete score ≥9 (expected within 60 minutes)
Incidence of any adverse effects.
Any side effects reported by the patient related to analgesia.
Time frame: from end of surgery (0 hours) to 8 hours postoperatively
Changes to mean arterial pressure (MAP)
changes to mean arterial pressure (MAP) (mmHg) before surgery, during surgery and immediately after surgey
Time frame: T0: before induction of anesthesia T1: after induction of anesthesia (within 5 minutes) T2: immediately after block placement (within 5 minutes) T3: start of surgery T4: every 10 minutes intraoperative until the end of surgery T5: end of surgery
Changes to oxygen saturation
Changes to oxygen saturation before surgery, during surgery and immediately after surgery.
Time frame: T0: before induction of anesthesia T1: after induction of anesthesia (within 5 minutes) T2: immediately after block placement (within 5 minutes) T3: start of surgery T4: every 10 minutes intraoperative until the end of surgery T5: end of surgery
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