Evaluation of a Femoralis, n Femoralis and m Iliopsoas Tendon Sonoanatomy According to Age Groups in Children

This study aims to examine the sonoanatomy of the inguinal region in children according to age groups.

Study Overview

• Status: Completed
• Conditions: Pediatrics; Anatomic Abnormality; Anatomy; Anatomic Landmarks; Anthropometry
• Intervention / Treatment: Device: ultrasound

Detailed Description

Regional anesthesia is frequently used in adults and children as part of multimodal analgesia or as a direct anesthesia method. Nowadays, these regional blocks can be applied more safely with the widespread use of ultrasound in daily clinical practice. Also, by identifying individual variations with ultrasound, the risk of block failure and possible complications has been minimized. Femoral nerve block and pericapsular nerve group block are now almost the first techniques used in hip and lower extremity surgeries or different indications. (1) Besides, these methods have become more advantageous in many aspects compared to spinal anesthesia in high-risk patients. However, to apply safe and successful regional anesthesia, both gross anatomy and sonoanatomy of the relevant region must be known well.

There are sufficient clinical and anatomical studies on these anesthesia methods applied in the inguinal region in adults, and there is no anatomical and anthropometric study in children. (2,3) However, well-known anatomic reference points for performing these blocks in adults may be different in children. (4) Therefore, with this study, we planned to develop appropriate anatomic reference points for these blocks in children by evaluating the relationship between sonography and inguinal region structures (such as distance, diameter measurement) in children's age groups.

• Study Type: Observational
• Enrollment (Actual): 150

Contacts and Locations

Study Locations

• Turkey
  • Yıldırım
    • Bursa, Yıldırım, Turkey, 16310
      • Bursa Yuksek Ihtisas Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 4 weeks to 18 years (Child, Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

All pediatric patients within the predetermined age group

Description

Inclusion Criteria:

• All pediatric patients

Exclusion Criteria:

• a previous surgical history to the related area

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

6

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Infants: 28 days - 12 month; inguinal sonoanatomy	Device: ultrasound; ultrasonography to inguinal region
small children: 13 months - 36 months; inguinal sonoanatomy	Device: ultrasound; ultrasonography to inguinal region
preschool age: 37 months - 72 months; inguinal sonoanatomy	Device: ultrasound; ultrasonography to inguinal region
school age: 73 months - 9 years; inguinal sonoanatomy	Device: ultrasound; ultrasonography to inguinal region
Preadolescant: >9 years - 12 years; inguinal sonoanatomy	Device: ultrasound; ultrasonography to inguinal region
Adolescants: >12 years - 18 years; inguinal sonoanatomy	Device: ultrasound; ultrasonography to inguinal region

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
femoral artery and femoral nerve distance (mm)	ultrasonographic measurements	1 hour
Body weight (gr)	measured at ward	1 hour
height (cm)	measured at ward	1 hour

Collaborators and Investigators

• Sponsor: Derince Training and Research Hospital
• Collaborators: Kocaeli University
• Investigators: Principal Investigator: Hande Gurbuz, Assoc. Prof., Bursa Yuksek Ihtisas Training and Research Hospital

Publications and helpful links

General Publications

• Giron-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular Nerve Group (PENG) Block for Hip Fracture. Reg Anesth Pain Med. 2018 Nov;43(8):859-863. doi: 10.1097/AAP.0000000000000847.
• Orozco S, Munoz D, Jaramillo S, Herrera AM. Pediatric use of Pericapsular Nerve Group (PENG) block for hip surgical procedures. J Clin Anesth. 2019 Nov;57:143-144. doi: 10.1016/j.jclinane.2019.04.010. Epub 2019 Apr 22. No abstract available.
• Frkovic V, Warmlander SK, Petaros A, Spanjol-Pandelo I, Azman J. Finger width as a measure of femoral block puncture site: an ultrasonographic anatomical-anthropometric study. J Clin Anesth. 2015 Nov;27(7):553-7. doi: 10.1016/j.jclinane.2015.07.015. Epub 2015 Aug 31.
• Yoshimura M, Nakanishi T, Sakamoto S, Toriumi T. Age is a predictive factor in the femoral nerve positioning: an anatomical ultrasound study. J Anesth. 2018 Oct;32(5):777-780. doi: 10.1007/s00540-018-2544-2. Epub 2018 Aug 21.
• Vloka JD, Hadzic A, Drobnik L, Ernest A, Reiss W, Thys DM. Anatomical landmarks for femoral nerve block: a comparison of four needle insertion sites. Anesth Analg. 1999 Dec;89(6):1467-70. doi: 10.1097/00000539-199912000-00028.

Study record dates

Study Major Dates

• Study Start (Actual): April 26, 2021
• Primary Completion (Actual): January 1, 2024
• Study Completion (Actual): January 25, 2024

Study Registration Dates

• First Submitted: April 22, 2021
• First Submitted That Met QC Criteria: April 22, 2021
• First Posted (Actual): April 27, 2021

Study Record Updates

• Last Update Posted (Actual): February 20, 2024
• Last Update Submitted That Met QC Criteria: February 16, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: pediatrics; PENG; sonoanatomy; inguinal region; variation; anatomy; femoral nerve; regional anesthesia; femoral artery
• Additional Relevant MeSH Terms: Congenital Abnormalities
• Other Study ID Numbers: 2011-KAEK-25

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No