Postoperative Pain Clinical Trial
Official title:
Transversus Abdominis Plane Versus Quadratus Lumborum Block for Pediatrics
The purpose of this research study is to find the best way to decrease pain in children whom
have had low abdominal surgery. Investigators will perform two technique of trunk block;
Transversus abdominis plane or Quadratus lumborum block .The method used is often chosen by
which one the doctor has more experience using. The Investigator plans to find out if one of
the methods is more effective and/or safer than the other method.
The results of this study will help learn how to best control pain in children having surgery
low abdominal surgery.
Children aged 1-7 years undergoing lower abdominal surgeries would be recruited in this
randomized study.
Children would be monitored by electrocardiogram, pulse oximeter and non-invasive blood
pressure.
After preoxygenation for three minutes, anesthesia would be induced with 8% sevoflurane
inhalation in 50% oxygen and % 50 air ; 1ug/kg fentanyl and 3 mg/kg propofol is administered
intravenously. Then laryngeal mask is inserted when conditions are satisfactory (jaw relaxed,
lash reflex disappeared, no coughing, gagging, swallowing).After ethical committee approval,
informed written consent will be obtained from all patients.
Consenting patients scheduled to have unilaterally low abdominal surgery(inguinal
hernia,hydrocele,undescended testicles surgery will be randomised to unilateral Quadratus
lumborum block or Transversus abdominis plane block at the begin of surgery.
All patients will be in the lateral position . Under ultrasound guidance a 22 Gauge, Pajunk
Sonoplex(medical Germany) needle will be used for both techniques. The spread of injectate
will be seed on ultrasound.The dose of local anaesthetic in both groups will be 0.5 ml/kg 0.2
% Bupivacaine. Anesthesia would be maintained with 2% sevoflurane An increase in blood
pressure or heart rate by more than 15% from preoperative value was defined as insufficient
analgesia and was treated with fentanyl 0.5 µ/kg. Saline dextrose 5% (1:1) solution was
infused in a dose of 12 ml/ kg /h.
All patients heart rate,MAP and Oxygen saturation record intraoperatively. All patients will
receive paracetamol if requirement for postoperative analgesia.All patient will transfer from
PACU to day-surgery unit (DSU) if they achieved Modified Aldrete Score of ten.
All patients will be assessed postoperatively by a blinded investigator: in the
postanesthesia care unit and at 30 min 1,2, 4, 6, 12, 24, hour postoperatively.FLACC score
will be used.
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