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This prospective randomized controlled trial aims to investigate the effect of ultrasound-guided selective supraclavicular nerve block on pain control after Hickman catheter, chemoport, or Perm cath insertion in children.
Pediatric patients undergoing surgical insertion of a Hickman catheter, chemoport, or Permcath are randomly assigned to a test group (Ultrasound-guided selective supraclavicular nerve block with Ropivacaine) and a control group (Nerve block is not performed).
Immediately after induction of general anesthesia, in the test group, the supraclavicular nerve block was selectively performed using ultrasound using 0.1mL/kg of 0.5% Ropivacaine (Maximum dose: 5mL), and the nerve block was not completed in the control group. After that, a Hickman catheter, chemoport, or Permcath is surgically inserted in the usual way and allowed to recover from anesthesia.
The pain score is evaluated between 10 and 30 minutes of entering the recovery room (1 hour after the procedure) and 1 hour, 3 hours, and 24 hours after leaving the recovery room by another research team who is unaware of the group assignment. In addition, the use of additional analgesic drugs and related side effects were collected before discharge.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Selective supraclavicular nerve block | Experimental | After induction of anesthesia, the anesthesiologist sterilizes the skin of the area to be punctured. In the test group, an Ultrasound-guided selective supraclavicular nerve block is performed using 0.5% Ropivacaine 0.1mL/kg (Maximum dose: 5mL). |
|
| Control | Active Comparator | The nerve block is not performed in the control group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine | Drug | The nerve involved in the operation of Hickman catheter, chemoport, and Perm cath is the supraclavicular nerve. Therefore, it is judged that if only this nerve is selectively blocked, pain control can be effectively performed with a small amount of local anesthetic, and relatively few side effects occur. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score | Wong-Baker Faces Pain Rating Scale is used | Pain score measured when communication is possible between 10 and 30 minutes after entering the recovery room. |
| Pain score | Numeric rating scale is also evaluated if communication is possible | Pain score measured when communication is possible between 10 and 30 minutes after entering the recovery room. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score | Wong-Baker Faces Pain Rating Scale is used | Pain score for 1 hour, 3 hours, and 24 hours after leaving the recovery room |
| Pain score | Numeric rating scale is also evaluated if communication is possible |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jin-Tae Kim, MD,PhD | Seoul National University Hospital, Seoul National University College of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jin-Tae Kim | Seoul | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37587734 | Derived | Park JB, Song IS, Kang PY, Ji SH, Jang YE, Kim EH, Lee JH, Kim HS, Kim JT. Ultrasound-guided selective supraclavicular nerve block for postoperative pain control in children receiving Hickman catheter or chemoport insertion: A randomized controlled trial. Paediatr Anaesth. 2024 Jan;34(1):35-41. doi: 10.1111/pan.14745. Epub 2023 Aug 16. |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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|
| Control (without intervention) | Other | No intervention |
|
| Pain score for 1 hour, 3 hours, and 24 hours after leaving the recovery room |
| Additional narcotic analgesics administered | Amount per body weight of additional narcotic analgesics administered. | Within 24 hours of the end of surgery |
| Additionally administered non-narcotic analgesics | Amount per body weight of additionally administered non-narcotic analgesics. | Within 24 hours of the end of surgery |
| Side effects related to pain medication | Nausea, Vomit, Constipation, Pruritus, Dizziness, Dry mouth, Sedation, etc. | Within 24 hours of the end of surgery |
| Complications related to ropivacaine use | Arrhythmia, Hypotension, ST change, Dizziness, Convulsion, etc. | Within 1 hour after procedure |
| Whether diaphragmatic palsy | It is confirmed by chest X-ray taken in the operating room. Diaphragmatic palsy can usually be suspected on chest X-rays showing abnormal hemidiaphragm elevation. Therefore, we will check the chest X-ray for abnormal hemidiaphragm elevation. | Within 24 hours of the end of surgery |
| Whether diaphragmatic palsy | It is confirmed by lung ultrasound in the recovery room. Hemidiaphragm visualization by ultrasound is achieved from an anterior approach, with the patient in a supine position. At the ultrasound, the diaphragm appears as a thick echogenic line. M-mode US may be used to measure the direction of diaphragmatic motion and the amplitude of excursion. The two indexes usually used for the diagnosis of diaphragmatic paralysis include a Tdi value <2 mm and a diaphragm thickening fraction (TFdi)value <20% [Tdi: The thickening of the diaphragm, TFdi: (thickness at the end of the inspiration - thickness at the end of expiration)/thickness at the end of expiration (in %)]. | Within 24 hours of the end of surgery |
| Hospital stay | The period from discharge from recovery room to discharge | No more than one month |
| Check the blockage | The quality of the selective supraclavicular nerve block will be tested with loss of cold sensation using an alcohol swab. | When communication is possible between 10 and 30 minutes after entering the recovery room. |
| D000588 |
| Amines |