The aim of the study is to compare postoperative analgesia in pediatric patients undergoing inguinal hernia repair by comparing the efficacy of ultrasound guided paravertebral block versus ultrasound guided erector spinae plane block.
None
None
Parallel
ultrasound guided paravertebral block
Procedure/Surgeryafter sterilization and identifying the level of T10 ,linear ultrasound probe will be placed in the midline over the spinous process at the chosen level, then the probe will be moved laterally to view the lamina and hyperechoic transverse process ,the pleural should be visible as a bright white line .The needle should be inserted in -plane from lateral to medial and the needle tip should end in a hypoechoic triangular space. Correct needle placement should be confirmed by anterior displacement of pleura with injection of small volume of saline then 0.5 ml/kg of a mixture of 0.25 ℅ bupivacaine and 1℅ lidocaine (1:1) will be injected
Ultrasound guided erector spinae plane block
Procedure/SurgeryAfter sterilization, the linear ultrasound probe will be placed over transverse process of T10 ,after optimizing the image in sagittal or transverse scanning ,A 50 mm 22-G needle will be placed under the erector spinae muscle in -in plane orientation until it contacted T8 transverse process in the cranial caudal direction ,after hydro dissection and confirmation that the tip of the needle is between the transverse process and the fascia of the erector spinae muscle group, 0.5 ml/kg of a mixture of 0.25 ℅bupivacaine and 1℅ lidocaine (1:1) will be injected
control group C
Procedure/Surgerywill receive standard general anesthesia with pain management protocol without regional block.
The total amount of rescue analgesia (Ibuprofen consumption)
The total consumption of rescue analgesia (Ibuprofen consumption) postoperative
Pain intensity at rest (static) and after movement or coughing (dynamic)
by using 10 points Modified Objective Pain Score (MOPS)(0=no pain, 1-3=mild pain, 4-6=moderate pain, and 7-10= sever pain)
The time to first request of rescue analgesia (Ibuprofen)
the time from giving block till time of first request of ibuprofen when MOPS \> 3 at rest or after movement
The total number of patients requiring additional dose of intraoperative fentanyl.
Number of patients receive additional dose of intra operative fentanyl ( increase in the mean blood pressure or heart rate 20% above base line readings, fentanyl in a dose 0.5 mcg/kg will be given to the patient)
To record the incidence of complications
To record the incidence of complications (hematoma, local anesthetic toxicity, pneumothorax, infection, hypotension, epidural or intrathecal spread)
Map coordinates are unavailable for these locations. Locations are shown below instead.
EgyptEgyptClick on the lead sponsor to view all of their trials.
