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Popliteal block is a technique for providing postoperative pain management in children. In this randomized double-blinded study, the investigators evaluated the effects of preoperative popliteal nerve block on postoperative pain and analgesic requirement in children with cerebral palsy (CP) undergoing knee-anckle soft tissue surgery. The Wong Baker faces scale and skin conductance fluctuations will be assessed.
Sevoflurane will be used for anesthesia induction and maintance. Laryngeal mask airway will be placed without neuromuscular blocking agent. In group P (popliteal block), a single dose of 0.3ml.kg(-1) of 0.25% bupivacaine will be performed for popiteal nerve block (with ultrasound guidence). In group C ( control), only plaster cover will be applied without nerve block for sham procedure to provide double-blinded study. Intraoperative heart rate, mean arterial pressure, BIS (bispectral index) values, sevoflurane consumption will be recorded ten minutes interval. Wong Baker faces scale and skin conductance fluctuations will be recorded at postoperative 0, 10th min, 20th min , 1st h, 4th h, 12th h qnd 24th h. Total analgesic consumption (paracetamol orally ) will be recorded.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| popliteal block | Active Comparator | Popliteal block will be performed with a single dose of 0.3 ml·kg(-1) of 0.25% bupivacaine. |
|
| Plaster cover | Sham Comparator | Only plaster cover will be applied without nerve block for sham procedure. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Popliteal block | Procedure | In group P, popliteal block will be performed with ultrasound guidence. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain assessment via Wong Baker faces scale | The patients will be followed up to 24 hours | |
| The number of fluctuations of skin conductance per second (NFSC). | The patients will be followed up to 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Taylan Akkaya | Ministry of Health Diskapi Yıldırım Beyazıt Training and Research Hospital | Study Chair |
| Mesut Bakır | Ministry of Health Diskapi Yıldırım Beyazıt Training and Research Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ministry of Health Diskapi Yıldırım Beyazıt Training and Research Hospital | Ankara | 06110 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17845649 | Result | Ledowski T, Bromilow J, Wu J, Paech MJ, Storm H, Schug SA. The assessment of postoperative pain by monitoring skin conductance: results of a prospective study. Anaesthesia. 2007 Oct;62(10):989-93. doi: 10.1111/j.1365-2044.2007.05191.x. | |
| 3353170 | Result | Johnston BM, Gunn TR, Gluckman PD. Surface cooling rapidly induces coordinated activity in the upper and lower airway muscles of the fetal lamb in utero. Pediatr Res. 1988 Mar;23(3):257-61. doi: 10.1203/00006450-198803000-00005. |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D002547 | Cerebral Palsy |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D000077149 | Sevoflurane |
| D014463 | Ultrasonography |
| D002045 | Bupivacaine |
| D017214 | Laryngeal Masks |
| ID | Term |
|---|---|
| D008738 | Methyl Ethers |
| D004987 | Ethers |
| D009930 | Organic Chemicals |
| D006845 | Hydrocarbons, Fluorinated |
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| Sevoflurane | Drug | Sevoflurane will be used to all patient's for anesthesia induction and maintenance |
|
| Ultrasound | Device | For recognize the nerve (sciatic nerve), ultrasound will be used in group P. |
|
| Plaster cover | Other | Plaster cover will be used to control group for sham procedure |
|
| bupivacaine | Drug | Bupivacaine 0.25% will be performed for popliteal block to group P. |
|
| Laryngeal mask airway | Other | After anesthesia induction, laryngeal mask airway will be inserted to all patients |
|
| 28197774 | Derived | Ozkan D, Gonen E, Akkaya T, Bakir M. Popliteal block for lower limb surgery in children with cerebral palsy: effect on sevoflurane consumption and postoperative pain (a randomized, double-blinded, controlled trial). J Anesth. 2017 Jun;31(3):358-364. doi: 10.1007/s00540-017-2318-2. Epub 2017 Feb 14. |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D001925 | Brain Damage, Chronic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006846 |
| Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D000813 | Anilides |
| D000577 | Amides |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D007442 | Intubation, Intratracheal |
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D007440 | Intubation |
| D008919 | Investigative Techniques |
| D008397 | Masks |
| D011482 | Protective Devices |
| D004864 | Equipment and Supplies |
| D000067393 | Personal Protective Equipment |
| D008420 | Manufactured Materials |
| D013676 | Technology, Industry, and Agriculture |