- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04921007
Ultrasound Guided Sacral Erector Spinae Plane Block in Pediatric Anorectal Surgery
Analgesic Efficacy of Ultrasound Guided Sacral Erector Spinae Plane Block Versus Caudal Block in Pediatric Anorectal Surgery
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Regional anesthesia in children has become increasingly popular over the past few decades. A variety of peripheral and central nerve blocks have been developed to ensure that perioperative pain can be effectively controlled. So, it possible to reduce the dose concentrations of systemic drugs and improved hemodynamic stability in high-risk patients. Erector spinae plane (ESP) block with various approaches been used in many surgeries and obtained great popularity despite of its novelty. After first description; lower thoracic, lumbar and sacral approaches were defined for postoperative analgesia. There are a few cases in which sacral ESP block was administered and reported.
The aim of this study is to compare postoperative analgesic effect of ultrasound guided sacral ESP block and caudal block. It is hypothesized that sacral ESP block will be comparable to caudal block as a promising effective alternative for analgesia in patients who will undergo pediatric anorectal surgery with fewer side effects.
This prospective, randomized, comparative clinical study will include 60 children who will be scheduled for elective anorectal surgery under general anesthesia in Mansoura university hospitals. Informed written consent will be obtained from parents of all subjects in the study after ensuring confidentiality. The study protocol will be explained to parents of all patients in the study who will be kept fasting prior to surgery. Patients will be randomly assigned to two equal groups (ESP and caudal) according to computer-generated table of random numbers using the permuted block randomization method. The collected data will be coded, processed, and analyzed using SPSS program. All data will be considered statistically significant if P value is ≤ 0.05.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Dakahlia
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Mansoura, Dakahlia, Egypt, 35511
- Department of Anesthesia, Mansoura University Hospitals
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- American Society of Anesthesiology (ASA) I and II patients.
- Scheduled for pediatric anorectal surgery
Exclusion Criteria:
- Parental refusal of consent.
- Children with developmental delays, mental or neurological disorders.
- Bleeding or coagulation diathesis.
- History of known sensitivity to the used anesthetics.
- Infection or redness at the injection site.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Group (A) Sacral ESP block
Ultrasound guided sacral erector spinae plane (ESP) block will be performed in the lateral position under sterile conditions, and bupivacaine will be administered.
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A high-frequency ultrasound linear probe covered with a sterile sheath will be placed longitudinally to the midline of the sacrum.
The median sacral crests and erector spinae muscle will be visualized, then a 22-gauge, 50 mm needle will be advanced from cranial to caudal direction until its tip touch the sacral crest.
Other Names:
Following negative aspiration, a precalculated dose (0.5 ml/kg) of 0.25% bupivacaine will be injected.
Other Names:
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Active Comparator: Group (B) Caudal block
Ultrasound guided caudal block will be performed in the lateral position under sterile conditions, and bupivacaine will be administered.
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Following negative aspiration, a precalculated dose (0.5 ml/kg) of 0.25% bupivacaine will be injected.
Other Names:
A high-frequency ultrasound linear probe covered with a sterile sheath will be placed on to the sacrococcygeal region.
The dura mater, epidural space, conus medullaris, sacral cornua, and sacrococcygeal ligament will be identified.
Using the in-plane technique, a 22-gauge, 50 mm needle will be introduced to reach the sacral epidural space.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Duration for the first analgesic request
Time Frame: Up to 24 hours after the procedure
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The time of the first analgesic request for paracetamol in minutes will be recorded.
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Up to 24 hours after the procedure
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total analgesic requirements of paracetamol
Time Frame: Up to 24 hours after the procedure
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The amount of paracetamol consumption in milligrams given as a rescue analgesia
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Up to 24 hours after the procedure
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Improvement in pain scores
Time Frame: Up to 24 hours after the procedure
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Pain score from 0 to 10 (0 = no pain and 10 = the worst imaginable pain) is assessed postoperatively at 1, 2, 4, 8, 12, 24 hours
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Up to 24 hours after the procedure
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Changes in heart rate
Time Frame: Up to end of the surgery
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Heart rate (beat/min) is recorded at ten-minute intervals until the end of the surgery.
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Up to end of the surgery
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Changes in mean arterial blood pressure
Time Frame: Up to end of the surgery
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Blood pressure (mmHg) is recorded at ten-minute intervals until the end of the surgery.
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Up to end of the surgery
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Changes in postoperative emergence agitation scale
Time Frame: Up to 30 minutes after the procedure
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Agitation is assessed using the 5- step Cravero scale (1-5) every five minutes from awakening and for 30 minutes.(1:Obtunded with no response to stimulation, 2:Asleep but responsive to movement or stimulation, 3:Awake and responsive, 4:Crying, 5:Thrashing behaviour that requires restraint)
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Up to 30 minutes after the procedure
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Value of parent satisfaction from the procedure
Time Frame: Up to 24 hours after the procedure
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The parents will be investigated postoperatively for the quality of the procedure verbally (0-10; 0=None, 10=total satisfaction)
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Up to 24 hours after the procedure
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Sacral ESP Block
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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