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Erector Spinae Plane Block for Peroperative Analgesia and Intraabdominal Tissue Oxygenation (ESPB)

19 mars 2020 uppdaterad av: Bezmialem Vakif University

The Evaluation of Ultrasonography-guided Erector Spinae Plane Block in Perioperative Analgesia and Intraabdominal Tissue Oxygenation in Pediatric Patients Undergoing Lower Abdominal Surgery

Brief summary: Regional anesthesia decreases the need for intravenous analgesia in the peri-operative period. Erector spinae plane (ESP) is a regional anesthesia technique shown to be effective at the dorsal and ventral rami of the thoracic spinal nerve along with sympathetic nerve fibers. The purpose is to demonstrate the contribution of ESP block to the postoperative analgesia by ultrasonography and to increase intraabdominal tissue oxygenation compared to the control group.

Studieöversikt

Status

Avslutad

Intervention / Behandling

Detaljerad beskrivning

50 patients with American Society of Anesthesiologists (ASA) physical score I-II were randomly divided into 25 patients in the ESP group and 25 patients in the control group. Patients were premedicated with oral midazolam 0.5 mg kg-1, 30 minutes before surgery Anesthesia monitorization was made with electrocardiogram, non-invasive blood pressure, peripheral oxygen saturation (SpO2), end-tidal carbon dioxide, temperature, Bispectral index (BIS), and Regional tissue saturation (rSO2). Anesthesia was induced with a face mask distributing 8% sevoflurane and 50% air in oxygen while the patients were breathing spontaneously. After anesthesia induction, peripheral venous access was established and propofol 2 mg kg-1 and fentanyl citrate 1 μg kg-1 were administered. Laryngeal mask airways were used to secure the upper airways. Anesthesia was maintained with sevoflurane and 50% air in oxygen. The concentration of sevoflurane was adjusted by targeting BIS scores at 50-60 in all groups. During the operations, fentanyl was administered at a dose of 0.5 μg kg-1 if the blood pressure and heart rates were 20% higher than the baseline value. In ESP blok groups, after general anesthesia induced, patients were placed in the lateral position and ESP block was performed under ultrasound guidance. For ESP block, 1: 1 ratio of 0.25% bupivacaine and 0.4 ml / kg of 1% lidocaine was administered. In all groups, regional tissue saturation (RSO2) was evaluated Continuously with near infrared spectroscopy (NIRS) probe from anesthesia induction to the end of surgery. Commercially available device (INVOS Cerebral Oximeter; somatics Corp, Troy, Mich) was used to monitor rSO2 values in the surgery side flank during surgical intervention. Pain was evaluated and recorded using the FLACC (Face, Legs, Activity, Cry, Consolability) scale at the 1st, 2nd, 8th, 12th and 24th hours. Total analgesic consumption was recorded during the operation and postoperative time to first analgesic drug and number of patients who required analgesic in the first 24 hours, parents satisfaction score, discharge time as well as adverse effects such as nausea and vomiting were recorded in the postoperative periods.

Studietyp

Interventionell

Inskrivning (Faktisk)

49

Fas

  • Inte tillämpbar

Kontakter och platser

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Studieorter

      • Istanbul, Kalkon, 34093
        • Parvin Pinar

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

6 månader till 2 år (Barn)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. Children aged 6 months to 2 years
  2. According to American Anesthesia Society Anesthesia Risk Scale ASA I-II class patients
  3. Patients with lower abdominal surgery

Exclusion Criteria:

  1. Children under 6 months and older than 2 years
  2. According to American Anesthesia Society Anesthesia Risk Scale Patients with ASA III-IV class
  3. Patients with contraindication to regional anesthesia
  4. Patients with a history of local anesthetic allergy
  5. Patients with abnormal coagulation profile
  6. Patients with infection at the injection site

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: ESP Group: Bupivacaine and lidocaine
ESP Group: Bupivacaine and lidocaine: Erector Spinae Plane Block : (1: 1 ratio of 0.25% bupivacaine and 0.4 ml / kg of 1% lidocaine) was administered.
ESP block was administered under general anesthesia before the surgery. Patients with ESP block, 1: 1 ratio of 0.25% bupivacaine and 0.4 ml / kg of 1% lidocaine
Andra namn:
  • ESP block
Inget ingripande: control group
Control Group:

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
FLACC scale
Tidsram: From recovery of anesthesia to end of study ( postoperative 24 hours)
FLACC scale was used. The Face, Legs, Activity, Cry, Consolability scale (FLACC) scale was a measurement used to assess pain for children between the ages of 6 months and 2 years or individuals that are unable to communicate their pain. The scale is scored in a range of 0-10 with 0 representing no pain. The scale has five criteria, which are each assigned a score of 0, 1 or 2.
From recovery of anesthesia to end of study ( postoperative 24 hours)
NIRS
Tidsram: Before anesthesia induction to end of operation ( intraoperative 2 hours )
INVOS ;Somatic Corp, Troy, Mic sensors placed in surgical side of patients was used to detect peripheral perfusion and oxygen delivery (rSo2)
Before anesthesia induction to end of operation ( intraoperative 2 hours )

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Time to first analgesic drug
Tidsram: first 24 hour
Time to first analgesic drug will be recorded
first 24 hour
Need for analgesic
Tidsram: first 24 hour
Number of patients who required analgesic in the first 24 hour
first 24 hour

Samarbetspartners och utredare

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Utredare

  • Studiestol: PARVIN PINAR, Bezmialem Vakif University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

18 januari 2019

Primärt slutförande (Faktisk)

12 april 2019

Avslutad studie (Faktisk)

20 april 2019

Studieregistreringsdatum

Först inskickad

13 december 2018

Först inskickad som uppfyllde QC-kriterierna

15 januari 2019

Första postat (Faktisk)

17 januari 2019

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

20 mars 2020

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

19 mars 2020

Senast verifierad

1 mars 2020

Mer information

Termer relaterade till denna studie

Läkemedels- och apparatinformation, studiedokument

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Kliniska prövningar på Kirurgi i nedre delen av buken

Kliniska prövningar på Bupivacaine and Lidocaine

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