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This study aims to compare between ultrasound guided external oblique intercostal plane block and ultrasound guided erector spinae plane block in paediatric upper abdominal surgeries.
Paediatric nerve blocks are increasingly recognized as new standard for managing pain in children. The advantages of regional anesthesia in this population include enhanced operating conditions, expedited recovery of bowel function, and reduced postoperative pain.
The caudal epidural block remains the most used method; however, the external oblique intercostal block, a novel technique involves administering local anesthesia deep to the external oblique muscle at the sixth intercostal space, thereby blocking thoracoabdominal nerves from T6 to T10. This technique offers several advantages, including straightforward anatomy, a single muscle strip that is easily identifiable even in obese patients, a bony backstop, and an easily expandable fascial plane that can accommodate a catheter.
The erector spinae plane block involves injecting local anesthetic into the fascial plane beneath the erector spinae muscle at the tip of the vertebral transverse process. This allows the local anesthetic to spread in the craniocaudal fascial plane.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I | Experimental | Patients will receive ultrasound-guided external oblique intercostal plane block. |
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| Group II | Experimental | Patients will receive ultrasound-guided erector spinae plane block. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| External oblique intercostal plane block | Other | Patients will receive ultrasound-guided external oblique intercostal plane block. |
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| Measure | Description | Time Frame |
|---|---|---|
| Degree of pain | Postoperative pain will be assessed using Faces pain score revised. The Faces Pain Scale revised (FPS-R) is a validated self-report instrument designed to measure pain intensity in pediatric populations. The scale comprises a series of facial expressions, ranging from a smiling face at 0, indicating "no pain," to a crying face at 10, indicating "very much pain". Children are instructed to select the face that most accurately reflects their current pain level. The faces are scored (0, 2, 4, 6, 8, 10), providing a quantifiable measure of pain intensity. | 12 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Heart rate will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative. | Every 15 minutes intraoperative |
| Mean arterial blood pressure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Belal M Hassan, MBBCH | Contact | 00201091397908 | Belal.bakr1420@alexmed.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Alexandria University | Recruiting | Alexandria | 21526 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Erector spinae plane block | Other | Patients will receive ultrasound-guided erector spinae plane block. |
|
Mean arterial blood pressure will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative.
| Every 15 minutes intraoperative |
| Peripheral oxygen saturation | Peripheral oxygen saturation will be recorded preoperative basal readings, after induction of anesthesia, during skin incision, and every 15 minutes intraoperative. | Every 15 minutes intraoperative |
| Duration of analgesia | Duration of analgesia will be recorded from block completion till first postoperative rescue analgesia requirement. | 12 hours after surgery |
| Total rescue analgesia requirement | In Faces Pain Scale score-revised, cut of points for analgesic requirement is ≧ 4, rescue analgesia will be administered in the form of nalbuphine 0.1 mg/kg, with a maximum dose of 0.2 mg/kg. | 12 hours after surgery |
| Incidence of complications | Incidence of complications including hematomas block failure, intravascular injection, pneumothorax or injection into the peritoneal cavity, with associated risks of damage to bowel and other abdominal viscera at the block site will be recorded. | 12 hours after surgery |