Dexmedetomidine Addition to Fascia Iliaca Compartment Block
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).
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 1
Contactos e Locais
Locais de estudo
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DK
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Mansoura, DK, Egito, 050
- Mansoura University Hospitals
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Prevenção
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Quadruplicar
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Comparador de Placebo: Group B
received 1 ml/kg bupivacaine 0.25%.
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Fascia iliaca compartment block was performed as described by Dalens et al technique.
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Comparador Ativo: group BD
received 1 ml/kg bupivacaine 0.25% with dexmedetomidine 2 μg/kg
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Fascia iliaca compartment block was performed as described by Dalens et al technique.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Postoperative pain scores
Prazo: every 4 hours after surgery
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Postoperative using the Objective Pain Scale (children <6 yr) which described by Hannallah et al.
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every 4 hours after surgery
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Vital signs
Prazo: before surgery, and every 20 min during surgery, and each 6 hours after surgery
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Heart rate, mean arterial pressure and oxygen saturation
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before surgery, and every 20 min during surgery, and each 6 hours after surgery
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Intraoperative hypotension
Prazo: for 24 hours after surgery
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for 24 hours after surgery
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Intraoperative bradycardia
Prazo: for 24 hours after surgery
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for 24 hours after surgery
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Postoperative sedation
Prazo: every 4 hours after surgery
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Sedation score was assessed using Ramsay's sedation
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every 4 hours after surgery
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Ghada F E l-Rahmawy, MD, Anesthesia and Surgical ICU, College of Medicine, Mansoura University, Mansoura City, Egypt
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- R 54
- R-54 (Outro identificador: Anestheia Dept., Mansoura University)
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