Ultrasound Guided Paravertebral Block Versus Erector Spinae Block for Postoperative Analgesia After Inguinal Hernia Repair in Pediatric Patients
Ultrasound Guided Paravertebral Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Inguinal Hernia Repair in Pediatric Patients: a Randomized Clinical Trial
Zagazig University
158 participants
Dec 30, 2024
INTERVENTIONAL
Conditions
Summary
The aim of the study is to compare postoperative analgesia in pediatric patients undergoing inguinal hernia repair by comparing the efficacy of ultrasound guided paravertebral block versus ultrasound guided erector spinae plane block.
Eligibility
Inclusion Criteria5
- - Parents acceptance
- \. Age: preschool and school age child (24 months-12 years old).
- \. Sex: both sex (males or females).
- \. Physical status: ASA 1\& II.
- \. Type of operation: elective unilateral inguinal hernia repair
Exclusion Criteria3
- - Patient with any contraindications of regional blocks (as coagulopathy or local infection at injection site)
- \. Patients with known history of allergy to the study drugs (bupivacaine and lidocaine).
- \. Advanced hepatic, renal, cardiovascular, neurologic and respiratory diseases.
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Interventions
after sterilization and identifying the level of T10 ,linear ultrasound probe will be placed in the midline over the spinous process at the chosen level, then the probe will be moved laterally to view the lamina and hyperechoic transverse process ,the pleural should be visible as a bright white line .The needle should be inserted in -plane from lateral to medial and the needle tip should end in a hypoechoic triangular space. Correct needle placement should be confirmed by anterior displacement of pleura with injection of small volume of saline then 0.5 ml/kg of a mixture of 0.25 ℅ bupivacaine and 1℅ lidocaine (1:1) will be injected
After sterilization, the linear ultrasound probe will be placed over transverse process of T10 ,after optimizing the image in sagittal or transverse scanning ,A 50 mm 22-G needle will be placed under the erector spinae muscle in -in plane orientation until it contacted T8 transverse process in the cranial caudal direction ,after hydro dissection and confirmation that the tip of the needle is between the transverse process and the fascia of the erector spinae muscle group, 0.5 ml/kg of a mixture of 0.25 ℅bupivacaine and 1℅ lidocaine (1:1) will be injected
will receive standard general anesthesia with pain management protocol without regional block.
Locations(2)
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NCT06752252