About this trial
This randomized, double-blinded, study aims to compare the efficacy of intraoperative and postoperative pain control while using bilateral ultrasound guided the pectoral nerves (PECS) versus transversus thoracic muscle plane block (TTPB) in pediatric patients undergoing corrective cardiac surgeries.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age: 6 months - 7 years.
Gender: both sexs .
Risk Adjustment for Congenital Heart Surgery (RACHS) II and III.
Patients undergoing cardiac surgeries requiring cardiopulmonary bypass with midline sternotomy incision.
Disqualifiers
Patients whose parents or legal guardians refuse to participate.
Preoperative mechanical ventilation.
Patients in coma, mental retardation, neurological disease, or on drugs affecting the behaviour.
Preoperative inotropic drug infusion.
Trial design
Parallel
Treatments tested in this trial
Control
DrugPatients will receive o.5 ug/kg/hr fentanyl infusion all through the whole operation.
Pectoral nerves (PECS)
Other interventionThis group will receive fentanyl infusion at a dose of (0.5 μg/kg/hr) all through the whole operation, plus ultrasound guided bilateral pectoral nerves (PECS) Block which will be done by injecting 0.4 ml/kg (1:1 solution of bupivacaine 0.25% and lidocaine 1%) at each side .
Transversus thoracic muscle plane block (TTPB)
Other interventionThis group will receive fentanyl infusion at a dose of (0.5 μg/kg/hr) all through the whole operation, plus Ultrasound guided bilateral transversus thoracic muscle plane block (TTPB) which will be done by injecting 0.4 ml/kg (1:1 solution of bupivacaine 0.25% and lidocaine 1%) at each side .
Treatment groups
Trial outcomes
Primary outcomes
The total dose of intraoperative fentanyl
The total dose of intraoperative fentanyl will be recorded
Secondary outcomes
Degree of pain
Pain will be assessed by the pediatric observational 10-point scale "Face, Leg, Activity, Cry, Consolability (FLACC) pain score immediately after admission to intensive care unit (ICU) then at 60 min, 2 hours, 4hours, 8hours and 12 hours postoperatively. If the patient FLACC score equal or more than 4, patient will receive Fentanyl I.V 1 mic /kg .
Heart rate
Heart rate (HR) immediately after admission to Intensive Care Unit (ICU) then at 60 min, 2 hours, 4hours, 8 hours and 12 hours
Mean arterial pressure
Mean arterial pressure (MAP) immediately after admission to Intensive Care Unit (ICU) then at 60 min, 2 hours, 4hours, 8 hours and 12 hours
Total consumption of Fentanyl
Total consumption of Fentanyl during the 1st 12 hours postoperatively will be recorded
Sponsors and contacts
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