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Dexmedetomidine Addition to Fascia Iliaca Compartment Block

15. mars 2015 oppdatert av: Mohamed R El Tahan, Mansoura University

Effects of Dexmedetomidine Addition to Bupivacaine on the Quality of Fascia Iliaca Compartment Block (FICB) in Children Undergoing Femur Fracture Surgery

Fractures of the shaft of femur (FSF) are common in children, especially isolated fractures of the mid-third of the femur which are intensely painful. The pain of the fracture is thought to originate from the femoral shaft periosteum and muscle spasm from the quadriceps mechanism. Fascia iliaca compartment block FIC is easy and simple technique, there is no need for high-skill or expensive equipments. It has higher success rate in more than 90%of the children thigh procedures.

Potentially dexmedetomidine has become an alternative to clonidine, it is a highly selective α2 agonist having about an 8-10 times affinity for α2 adrenergic receptors than clonidine and much less α1 effects, which is responsible for the hypnotic and analgesic effects. Perinural dexmedetomidine in combination with bupivacaine or ropivacaine enhance sensory and motor block without neurotoxicity in experimental studies.It has been reported to improve the quality of intrathecal, Epidural, and caudal anesthesia in children. Also, it is safe and effective in IV regional anesthetic and axillary block in adult. No study-up to the date -has been carried to evaluate its effect on the character of fascia iliaca compartment blocks as adjuvant to bupivacaine. The objectives of this study were designed to detect the effects of addition dexmedetomidine (Precedex- Abbot) as adjuvant to bupivacaine for fascia iliaca block on the quality of postoperative analgesia and also to determine its effects on the hemodynamics, recovery behaviors, sedation and possible side effects in children undergoing thigh surgeries (fracture femur).

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

All the patients were premedicated with oral midazolam 0.5 mg/kg,1 hour prior to induction. General anesthesia was induced by inhaled sevoflurane.

Laryngeal mask airway with appropriate-size for body weight was slipped, then an intravenous line was inserted,anesthesia was maintained with sevoflurane (Minimum Alveolar Concentration (MAC)from 1-1.5 in air/oxygen to maintain the Heart rate (HR) and mean arterial blood pressure (MAP) within 20% of their baseline values.

A rescue dose of fentanyl 0.5 µg/kg was given if the MAC of sevoflurane exceeded 1.7 whereas HR and MAP exceeded 20% of their baseline values.

Fascia iliaca compartment block was performed as described by Dalens et al technique.

An axillary nerve block needle was inserted with an angle of 45±60º with the skin at (0.5±1cm) below the inguinal crease at the junction of the medial two-thirds and the lateral one-third of the line between the pubic tubercle and anterior superior iliac spine.

The needle was advanced until the perception of two losses of resistance (pop) was noted which corresponded to the crossing of fascia lata and then fascia iliaca.

Hypotension was defined as systolic arterial pressure 70 plus twice the age in years and associated with altered peripheral perfusion.

Bradycardia was defined as HR below 80 beats/min. Delayed anesthetic emergence was defined as 20 min elapsing from the end of surgery to exiting the operating theater.

Studietype

Intervensjonell

Registrering (Faktiske)

28

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Egypt
    • DK
      • Mansoura, DK, Egypt, 050
        • Mansoura University Hospitals

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

2 år til 6 år (Barn)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Children 2-6 years
  • American Society of Anesthesiologist physical class I and II
  • Fracture femur surgery

Exclusion Criteria:

  • known allergy to the study drugs
  • suspected coagulopathy
  • infection at the site of the block
  • neurological diseases
  • history of developmental delay

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Placebo komparator: Group B
received 1 ml/kg bupivacaine 0.25%.
Fremgangsmåte: Fascia iliaca compartment block
Fascia iliaca compartment block was performed as described by Dalens et al technique.
Aktiv komparator: group BD
received 1 ml/kg bupivacaine 0.25% with dexmedetomidine 2 μg/kg
Fremgangsmåte: Fascia iliaca block
Fascia iliaca compartment block was performed as described by Dalens et al technique.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Postoperative pain scores
Tidsramme: every 4 hours after surgery
Postoperative using the Objective Pain Scale (children <6 yr) which described by Hannallah et al.
every 4 hours after surgery

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Vital signs
Tidsramme: before surgery, and every 20 min during surgery, and each 6 hours after surgery
Heart rate, mean arterial pressure and oxygen saturation
before surgery, and every 20 min during surgery, and each 6 hours after surgery
Intraoperative hypotension
Tidsramme: for 24 hours after surgery
for 24 hours after surgery
Intraoperative bradycardia
Tidsramme: for 24 hours after surgery
for 24 hours after surgery
Postoperative sedation
Tidsramme: every 4 hours after surgery
Sedation score was assessed using Ramsay's sedation
every 4 hours after surgery

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Mansoura University

Etterforskere

  • Hovedetterforsker: Ghada F E l-Rahmawy, MD, Anesthesia and Surgical ICU, College of Medicine, Mansoura University, Mansoura City, Egypt

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2012

Primær fullføring (Faktiske)

1. mars 2012

Studiet fullført (Faktiske)

1. mai 2012

Datoer for studieregistrering

Først innsendt

14. mai 2012

Først innsendt som oppfylte QC-kriteriene

15. mai 2012

Først lagt ut (Anslag)

16. mai 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

17. mars 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

15. mars 2015

Sist bekreftet

1. mars 2015

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • R 54
  • R-54 (Annen identifikator: Anestheia Dept., Mansoura University)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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