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This study aims to evaluate the safety and efficacy of ultrasound-guided sacral multifidus plane block and compare its analgesic effect to ultrasound-guided caudal block in pediatric patients undergoing hypospadias surgery under general anesthesia
Peri-operative pain management in pediatric surgeries is considered a challenging issue for the anesthesiologists. The usage of regional anesthesia in association with general anesthesia (GA) is a simple intraoperative way that reduces (GA) requirements and side effects. Recently, paraspinal fascial plane block, the sacral multifidus plane block (MPB), was used successfully in infants. The study has been designed to determine the effect of MPB versus caudal epidural block to control peri-operative pain in hypospadias surgeries in children.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Multifidus plane block (MPB) group | Experimental | Participants will be injected bupivacaine at the fascial plane between the multifidus muscle and the median sacral crests of S2 and S3 |
|
| Caudal block (CB) group | Experimental | Participants will be injected by bupivacaine, between the two sacral cornua |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multifidus plane block | Procedure | Using the "in-plane" technique,The fascial plane between the multifidus muscle and the median sacral crests of S2 and S3, will be injected by bupivacaine. |
| Measure | Description | Time Frame |
|---|---|---|
| is to measure the first time to rescue analgesia postoperative (24 hours). | Measure the first time to rescue analgesia post operative | 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | measuring HR changes | start to end of surgery |
| Blood pressure | measuring BP changes | start to end of the surgery. |
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Inclusion Criteria:
⦁ Children aged (1 -7) years old.
Exclusion Criteria:
⦁ Parents refusing to participate are excluded from the trial.
Children aged (1 -7) years old.All patients will be of ASA classification I, II physical status
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain Shams University | Cairo | 11772 | Egypt |
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| ID | Term |
|---|---|
| D007021 | Hypospadias |
| ID | Term |
|---|---|
| D014564 | Urogenital Abnormalities |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| caudal block | Procedure | The ultrasound transducer will first be placed transversely at the midline to obtain the transverse view of sacral hiatus. At this level, the ultrasound transducer is rotated 90 degrees to obtain the longitudinal view of sacral hiatus. The block needle is inserted using the "in-plane" technique. |
|
| D010409 | Penile Diseases |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D052801 | Male Urogenital Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |