scholarly journals Comparison between caudal epidural block and popliteal nerve block for postoperative analgesia in children undergoing foot surgery: a randomized controlled trial

2020 ◽  
Vol 8 (2) ◽  
pp. 560
Author(s):  
Tailang Bumer ◽  
Lokesh Kashyap ◽  
M. K. Arora ◽  
R. K. Batra ◽  
Ganga Prasad ◽  
...  
Keyword(s):  
Nerve Block ◽  
Postoperative Analgesia ◽  
Controlled Trial ◽  
Demographic Data ◽  
Epidural Block ◽  
Block Group ◽  
Foot Surgery ◽  
Significant Difference ◽  
Caudal Epidural Block ◽  
Caudal Epidural

Background: Pain following surgery in children cause discomfort, restlessness and agitation in the postoperative period which may result in an increased incidence of nausea, vomiting and maladaptive behavioural changes. Regional anaesthesia is commonly used as an adjunct to general anaesthesia for perioperative analgesia in children as part of a multimodal approach of pain relief. This study is to compare between caudal epidural block and popliteal nerve block for postoperative analgesia in children undergoing foot surgery.Methods: A prospective randomized single blind study was carried out on 30 children aged 1-12 years of either sex undergoing foot surgery. Patients were randomly assigned into caudal epidural block group and Popliteal nerve block group, 15 children each. Both groups receive 1 ml/kg of 0.25% bupivacaine. Foot surgery was carried out under general anesthesia along with regional block for all children. After completion of surgery, children were shifted to PACU and HR, BP, SPO2 were monitored. Patient was discharged from PACU after CHEOPS (1-5 years) or VAS (6-12 years) <4. Parental satisfaction, sedation score, PONV, and any other side effects were recorded.Results: Demographic data and baseline vital signs were comparable between two groups. Statistically significant difference (p=0.025) in number of attempts in giving block in group A (1.20±0.41) than group B (1.80±0.86). The mean postoperative pain scores, CHEOPS and VAS were comparable in both groups.Conclusions: Both caudal epidural block and popliteal nerve block provides comparable and adequate analgesia in children undergoing elective foot surgery.

scholarly journals Postoperative Analgesia for the Surgical Correction of Congenital Clubfoot. Comparison between Peripheral Nerve Block and Caudal Epidural Block

2009 ◽  
Vol 59 (6) ◽  
pp. 684-693 ◽  
Author(s):  
Monica Rossi Rodrigues ◽  
Franklin Cêspedes Paes ◽  
Leonardo Teixeira Domingues Duarte ◽  
Luiz Guilherme Nadal Nunes ◽  
Verônica Vieira da Costa ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Peripheral Nerve Block ◽  
Epidural Block ◽  
Surgical Correction ◽  
Congenital Clubfoot ◽  
Caudal Epidural Block ◽  
Caudal Epidural

scholarly journals Postoperative pain management for circumcision; Comparison of frequently used methods

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Caglar Münevveroglu ◽  
Mehmet Gunduz
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Epidural Block ◽  
Block Group ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
Caudal Epidural Block ◽  
Caudal Epidural ◽  
Penile Block

Objective: To determine the ideal method for postoperative pain management after circumcision by comparing the most frequently used different methods like; dorsal penile block, caudal epidural block, subcutaneous ring block, intravenous paracetamol and intravenous tramadol HCl. Methods: Between May 1st 2015 to May 1st 2016, 500 children between 2-10 year old were circumcised at the department of pediatric surgery of Istanbul Medipol University Health Care Practice & Research Center Sefakoy Hospital. Five groups were formed according to postoperative analgesia methods which were planned to be compared; Group-I. penile block, Group-II. Caudal epidural block, Group-III. subcutaneous ring block, Group-IV as intravenous paracetamol and Group-V as intravenous tramadol HCl. In order to evaluate the postoperative pain levels of children, Children’s Hospital Eastern Ontario Pain Scale (CHEOPS) was filled at 30, 60, 120, 180 minutes after circumcision by a researcher who does not know which method was applied. Results: No significant difference is found between the groups (p>0.05). In the statistical analysis, no significant difference was found in the effect of analgesia methods on CHEOPS scores between 30, 60, 120 and 180 minutes (p>0.05). In parallel with this result, no significant difference was found in the effect of heart beat rates and respiration rate averages between 30, 60, 120 and 180 minutes (p>0.05). Conclusion: It has been shown that none of the five method has any superiority in reducing pain after circumcision and that all five methods can be used. However, we think that side effects of regional anesthesia and systemic analgesic applications should not be ignored. doi: https://doi.org/10.12669/pjms.36.2.505 How to cite this:Munevveroglu C, Gunduz M. Postoperative pain management for circumcision; Comparison of frequently used methods. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.505 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comparison of caudal and intravenous dexamethasone as adjuvants for caudal epidural block: A double blinded randomised controlled trial

2016 ◽  
Vol 60 (12) ◽  
pp. 948 ◽  
Author(s):  
Bharath Srinivasan ◽  
Rakesh Karnawat ◽  
Sadik Mohammed ◽  
Bharat Chaudhary ◽  
Anil Ratnawat ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Epidural Block ◽  
Caudal Epidural Block ◽  
Randomised Controlled ◽  
Double Blinded ◽  
Caudal Epidural

A Randomized Controlled Trial Assessing the Effect of a Continuous Subcutaneous Infusion of Local Anesthetic Following Elective Surgery to the Great Toe

2016 ◽  
Vol 10 (2) ◽  
pp. 116-124 ◽  
Author(s):  
Barry Rose ◽  
Kumar Kunasingam ◽  
Tristan Barton ◽  
James Walsh ◽  
Karen Fogarty ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Continuous Infusion ◽  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Demographic Data ◽  
Randomised Control Trial ◽  
Randomized Controlled ◽  
Significant Difference

Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours. Pain scores were recorded on postoperative days 1 and 7. There were more females than males. Follow-up was 100%. There were no significant differences in demographic data between the 2 randomized groups. There was no significant difference between the absolute visual analog scale scores on day 1 (P = .14) and day 7 (P = .16); nor was there a significant difference in reduction in scores between days 1 and 7 (P = .70). This study has shown no benefit to postoperative analgesia with the use of a continuous infusion of ropivacaine at the ankle. We, therefore, cannot currently recommend its use in the way described. Further studies may still identify a role for continuous local anesthetic infusions at the ankle to improve postoperative analgesia. Levels of Evidence: Level I : Prospective randomised control trial.

scholarly journals Clonidine as an Additive to Local Anesthetics in Caudal Block for Postoperative Analgesia in Pediatric Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ye Wang ◽  
Qianqian Guo ◽  
Qi An ◽  
Lin Zhao ◽  
Meng Wu ◽  
...  
Keyword(s):  
Pain Score ◽  
Postoperative Analgesia ◽  
Pediatric Surgery ◽  
Meta Analysis ◽  
Epidural Block ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Control Drug ◽  
Caudal Epidural Block ◽  
Caudal Epidural

Background: Clonidine is an anesthetic with favorable efficacy and safety profiles for caudal epidural block, but comparisons with other adjuvants need to be confirmed in pediatric patients.Aim: To investigate the effects of clonidine as an adjuvant in caudal epidural block to improve the intraoperative and postoperative analgesia in pediatric surgery.Methods: PubMed, Embase, and the Cochrane Library were searched for available papers published up to February 2021. The outcomes were pain score, duration of analgesia, complications, and number of analgesic requirements. The meta-analysis was performed using random-effects models.Results: Fifteen randomized controlled trials (RCTs) were included. There were no differences between clonidine and the control drug regarding the duration of analgesia (SMD = −0.71, 95%CI: −1.64, 0.23; I2 = 95.5%, Pheterogeneity &lt; 0.001), pain score (SMD = 0.35, 95%CI: −0.28, 0.98; I2 = 80.8%, Pheterogeneity &lt; 0.001), and requirement for additional analgesia (OR = 8.77, 95%CI: 0.70, 110.58, I2 = 81.9%, Pheterogeneity = 0.004), but using clonidine resulted in fewer complications than the control drugs (OR = 0.33, 95%CI: 0.20, 0.54, I2 = 21.8%, Pheterogeneity = 0.217). The sensitivity analysis showed that the results were robust. A publication bias was observed.Conclusion: Clonidine has the same efficacy as the other adjuvants for caudal epidural block for pediatric surgery but fewer complications. These results support clonidine as an adjuvant to local anesthetic, but additional studies should be conducted.

scholarly journals The Termination Level of the Dural Sac Relevant to Caudal Epidural Block in Lumbosacral Transitional Vertebrae: A Comparison between Sacralization and Lumbarization Groups

2018 ◽  
Vol 1 (21;1) ◽  
pp. 73-81 ◽  
Author(s):  
Yu Mi Jeong
Keyword(s):  
Back Pain ◽  
Epidural Block ◽  
University Hospital ◽  
Dural Sac ◽  
Significant Difference ◽  
Caudal Epidural Block ◽  
The Mean ◽  
Lumbosacral Transitional Vertebrae ◽  
Caudal Margin ◽  
Caudal Epidural

Background: Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and have been considered as one of the reasons for back pain. It is not unusual for clinicians to encounter patients with LSTV who require caudal epidural block (CEB) for pain management. Objective: We investigated the termination level of the dural sac (DS) and anatomical features of the lumbosacral region relevant to CEB in patients with LSTV and compared these findings between sacralization and lumbarization groups. Study Design: A retrospective evaluation. Setting: A university hospital with inpatient and outpatient LSTV cases presenting low back pain. Methods: Four hundred ninety-four LSTV patients were included and categorized into sacralization (n = 201) or lumbarization groups (n = 293). Magnetic resonance imaging (MRI) of all of the LSTV patients were reviewed to determine the level of DS termination, the shortest distance between the apex of the sacral hiatus and DS, and the presence and the caudal level of sacral perineural cysts. Each lumbosacral vertebra column was divided into 3 equal portions (upper, middle, and lower thirds). The MRI findings in both of the groups were compared and analyzed. Results: The distribution frequency of the levels of DS termination demonstrated a significant difference between the 2 groups. The mean caudal DS level in the lumbarization group was significantly lower than the sacralization group (lower third of the S2 [131 {44.7%} of 293 patients] vs. lower third of the S1 [78 {38.8%} of 201 patients]). The DS terminated at the S3 in more than 19% of the lumbarization group, whereas in only one case of the sacralization group. Although the incidence of perineural cysts was not significantly different between the 2 groups, the mean level of caudal margin of perineural cysts in the lumbarization group was significantly lower than the sacralization group (middle third of the S3 [10 {35.7%} of 28 cases] vs. middle third of the S2 [11 {44%} of 25 cases]). Limitations: This study reveals several limitations including the practical challenge of accurate enumeration of the transitional segment and the constraints on generalizability posed by the single-country study. Conclusion: When planning CEB for patients with LSTV, pre-procedural MRI to check the anatomical structures, including the level of DS termination and caudal margin of perineural cysts, would be of great use for lowering the risk of unexpected dural puncture during the procedure, especially in the lumbarization cases. Key words: Termination of the dural sac, dural sac termination, lumbosacral transitional vertebrae, transitional vertebra, caudal epidural block

Effect of ilioinguinal nerve block on the catecholamine plasma levels in orchidopexy: comparison with caudal epidural block

2002 ◽  
Vol 12 (9) ◽  
pp. 791-797 ◽  
Author(s):  
Mostafa Somri ◽  
Luis A. Gaitini ◽  
Sonia J. Vaida ◽  
Boris Yanovski ◽  
Edmond Sabo ◽  
...  
Keyword(s):  
Nerve Block ◽  
Plasma Levels ◽  
Epidural Block ◽  
Ilioinguinal Nerve ◽  
Caudal Epidural Block ◽  
Caudal Epidural
Sign in / Sign up

Export Citation Format

Share Document