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This study intends to evaluate the effect of erector spinae plane block on postoperative analgesia and sleep quality in infants with congenital cystic pulmonary disease after thoracoscopic surgery, and provides reference for perioperative pain treatment in children.
Severe pain may occur after pediatric thoracic surgery, such as skin incision, rib traction, drainage tube placement, or intercostal nerve dysfunction caused by suture. Pain may cause weakened coughing power to clear secretions, decreased functional residual capacity, leading to pulmonary complications such as atelectasis and pneumonia, and postoperative acute pain develops into chronic pain. It has been reported that postoperative sleep disorders are associated with increased pain scores, which are very unfavorable for postoperative rehabilitation of pediatric patients. In clinical practice, because infants cannot accurately describe pain, their postoperative pain management may not be sufficient and has not received enough attention. But, some studies have shown that infants may feel more severe pain than adults, and the pain has a more obvious and lasting effect on infants and young children than on adults.
Congenital pulmonary cystic disease is a rare congenital pulmonary developmental abnormality in clinic. It can't heal itself and is easy to cause various complications. Once diagnosed, surgical treatment should be considered immediately.
In the past experience, thoracic epidural block and thoracic paravertebral nerve block are commonly used for postoperative analgesia in thoracic surgery, but they have taboos such as abnormal coagulation function, high technical requirements and potential risks of serious complications.
Since the erector spinae plane block (ESPB) was first reported and successfully implemented in 2016, because it is far away from the neural axis, major vascular structures, pleura and other structures, with a lower possibility of complications, simpler operation and higher safety, it has been widely used in perioperative analgesia and acute and chronic pain in cardiothoracic surgery, breast surgery, abdominal surgery, spinal surgery, etc. However, the reports on pediatric patients are still mainly case reports, and there is a lack of large-sample randomized controlled clinical trials. Therefore, this study intends to perform erector spinae plane block under ultrasound guidance to observe the effect on postoperative analgesia and sleep quality in pediatric thoracoscopic surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| E group | Experimental |
| |
| P group | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ropivacaine | Drug | 0.25 % ropivacaine ( 0.5ml / kg ) |
| |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative FLACC score | 2, 4, 6, 12, 24, 48 hours after operation |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative sleep quality score | The Pittsburgh Sleep Quality Index was used to evaluate the sleep quality of children 7 days after surgery. | 1, 2, 3, 4, 5, 6, 7 days after operation |
| Number of participants with emergence agitation as assessed by PAED |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Xiaoming Lei, chief physician | Second Affiliated Hospital of Xi 'an Jiaotong University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Second Affiliated Hospital of Xi 'an Jiaotong University | Xi’an | Shanxi | 710004 | China |
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| erector spinae plane block |
| Procedure |
After the operation, unilateral erector spinae plane block was performed at the T5 level under ultrasound guidance. |
|
| Incision infiltration of local anesthesia | Procedure | After the operation, Incision infiltration of local anesthesia is performed around the surgical incisions. |
|
The Pediatric Anesthesia Emergence Delirium (PAED) was used to evaluate emergence agitation after extubation in post-anesthesia care unit. |
| from extubation to the child is sent back to the ward, an average of 40 minutes |
| the amount of postoperative rescue analgesia ( with a FLACC score of >4) | ibuprofen (5-10mg/kg) was intravenously administered as rescue analgesia. | 2, 4, 6, 12, 24, 48 hours after operation |
| ID | Term |
|---|---|
| D015615 | Cystic Adenomatoid Malformation of Lung, Congenital |
| D001998 | Bronchopulmonary Sequestration |
| D001994 | Bronchogenic Cyst |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D015619 | Respiratory System Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D003560 | Cysts |
| D009369 | Neoplasms |
| D001982 | Bronchial Diseases |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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