This study aims to compare ultrasound guided subtransverse process interligamentary plane block versus rhomboid intercostal block combined with sub-serratus plane block for postoperative analgesia in pediatric thoracotomy.
Post-thoracotomy pain is one of the most severe types of pain on the first day of the surgery. In pediatric patients, inadequate analgesia may lead to adverse circulatory and respiratory compromise. The subtransverse process interligamentary (STIL) plane block is a recently introduced technique that offers a safer alternative by targeting thoracic nerves without entering the paravertebral space. Recently, some studies have shown that the rhomboid intercostal block (RIB) and the RIB combined with the sub-serratus plane block (RISS) can provide good analgesia effects after video assisted thoracoscope.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
75
Patients will receive no block intervention and standard intravenous analgesia will be given.
Patients will receive ipsilateral ultrasound-guided subtransverse process interligamentary (STIL) plane block with bupivacaine 0.25% (0.5 mL/kg) after induction of general anesthesia.
Patients will receive ipsilateral ultrasound-guided rhomboid intercostal block (RIB) combined with sub-serratus plan block group with bupivacaine 0.25% (0.5mL/kg) after induction of general anesthesia.
Tanta University
Tanta, El-Gharbia, Egypt
RECRUITINGTime to first rescue analgesia
Time to the first rescue analgesia will be recorded from the end of surgery till first dose of morphine adminstrated.
Time frame: 24 hours postoperatively
Degree of pain
Each patient will be instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed after surgery over 24 hours (30 minutes postoperative, 2, 4, 6, 12, 24 hours.
Time frame: 24 hours postoperatively
Total Opioids consumption
Morphine 0.05 mg /kg IV will be given as rescue analgesia if VAS score ≥4, morphine dose will not exceed 0.3 mg/kg/day.
Time frame: 24 hours postoperatively
Intraoperative fentanyl consumption
Fentanyl 0.5 μg/kg will be administrated in the case of inadequate analgesia that defined as an un explained increase of heart rate (HR) and/or mean arterial blood pressure (MAP) more than 20% above the preoperative values after exclusion of other causes.
Time frame: Intraoperatively
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