scholarly journals The Analgesic Efficacy of Ultrasound-Guided Quadratus Lumborum Block Versus Ultrasound-Guided Caudal Block for Hip Surgery in Pediatrics: A Prospective Randomized Study

2021 ◽  
pp. 58-68
Author(s):  
Islam M. Salim ◽  
Shimaa M. EL. Rahwan ◽  
Mohamed M. Abu Elyazd ◽  
Lobna M. Abo Elnasr
Keyword(s):  
General Anesthesia ◽  
Pediatric Patients ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Surgical Correction ◽  
Nausea And Vomiting ◽  
Block Group ◽  
Caudal Block ◽  
Ultrasound Guided ◽  
Quadratus Lumborum

Background: Ultrasound-guided quadratus lumborum (QL) block, is local anesthetic technique providing perioperative somatic, perhaps even visceral, analgesia for patients of all ages. The aim of this study is to evaluate the analgesic efficacy of ultrasound-guided anterior QL block versus ultrasound-guided caudal block in pediatric patients undergoing hip surgery. Patients and Methods: This prospective, randomized study was carried out on seventy patients aged 1-7 years, of both with ASA physical status I or II scheduled for elective surgical correction of developmental dysplasia of hip (DDH). Anterior QL Block Group: Patients received ipsilateral ultrasound-guided anterior QL block after induction of general anesthesia using of bupivacaine 0.25% (0.5 mL/kg). Caudal Block Group: Patients received ultrasound-guided caudal block after induction of general anesthesia using of bupivacaine 0.25% (0.75 mL/kg). Postoperative pain scores were assessed on admission to PACU and at 1, 2, 4, 6, 8, 12, 18 and 24 h postoperative. Total intraoperative fentanyl (µg) consumption, total postoperative rescue analgesic (morphine) consumption, time to the first rescue analgesic administration and Parent satisfaction were assessed. Heart rate and mean arterial blood pressure had been recorded pre–operative, every 15 min intra-operative , and postoperative on admission to PACU and at 1, 2, 4, 6, 8, 12, 18 and 24 h postoperative. Any undesirable side effects during the first 24 hours such as, bradycardia, hypotension, local hematoma at the side of injection, nausea and vomiting had been recorded. Results: The median FLACC score was significantly lower in anterior QL block group than caudal block group at 4,6,8 and 12h postoperative (P<0.001). Total intraoperative fentanyl (µg) consumption was insignificant different between both groups (P=0.862). Post-operative morphine consumption was significantly lower in anterior QL group compared to caudal group (P<0.001). Time to first postoperative analgesic requirement was significantly prolonged in anterior QL block group compared to caudal block group (P < 0.001). The incidence of nausea and vomiting was insignificantly different between both groups (P > 0.999). Conclusions: Ultrasound-guided anterior QL block provided effective and long lasting postoperative analgesia than ultrasound-guided caudal block with lesser postoperative analgesic consumption in pediatric patients undergoing surgical correction of DDH.

scholarly journals A Comparative Study between Effects of Ultrasound Guided Ilioinguinal /Iliohypogastric Nerve Block versus Caudal Block on Postoperative Analgesia in Children Undergoing Inguinal Surgery

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M H Nafie ◽  
W A Altaher ◽  
G N Nassef ◽  
M M W Ahmed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
General Anesthesia ◽  
Nerve Block ◽  
Pain Control ◽  
Block Group ◽  
Caudal Block ◽  
Ultrasound Guided ◽  
Intravenous Morphine ◽  
Caudal Epidural

Abstract Background The most commonly performed inguinal surgeries in children include inguinal hernia repair with or without orchidopexy and hydrocele repair. For postoperative pain with these surgeries, a regional analgesic modality such as caudal analgesia (CA), ilioinguinal and iliohypogastric nerve block (IL/IH), or even local infiltration is combined with a general anaesthetic (GA). Regional analgesia techniques are commonly used to facilitate pain control during pediatric surgical practice, decrease parenteral opioids requirements and improve the quality of post-operative pain control and patient-parent satisfaction. When compared to intravenous (IV) opioids, regional techniques reduce the risk of side effects such as somnolence, respiratory depression, emesis, and ileus. Patients and Methods: After approval of anesthesia, intensive care and pain management department, scientific and ethical committees, and after informed parental written consents, this prospective randomized clinical trial study was conducted in Ain Shams University Hospitals. This study is considered to be a pilot exploratory study. Forty five children patients were included in the study scheduled for elective inguinal surgeries (e.g.; unilateral inguinal hernia repair, hydrocele repair, or orchidopexy). Patients will be randomized using a random number table and the use of a closed envelopes technique to receive either combined general anesthesia with ultrasound guided caudal block (Group A), combined general anesthesia and ultrasound guided ilioinguinal /iliohypogastric block (Group B), or general anesthesia with intravenous morphine (group C). Results Among 45 children of (27 boys and 18 girls), aged from one to six years old, ASA physical status I–II who were scheduled for elective unilateral inguinal surgeries, fifteen patients received general anesthesia with ultrasound guided caudal epidural anesthesia (1ml/kg bupivacaine 0.25%), fifteen patients received general anesthesia with ultrasound-guided ilioinguinal/ iliohypogastric nerve block (0.5ml/kg bupivacaine 0.25%) and fifteen patient received general anesthesia with intravenous morphine (0.1 mg/kg). Conclusion The current study demonstrated that ultrasound-guided ilioinguinal /iliohypogastric nerve block was more effective than ultrasound guided caudal epidural block or intravenous morphine usage in children aged 1-6 years old undergoing unilateral inguinal surgeries as it carried the advantages of faster onset of action, longer duration of postoperative analgesia, the need of lower volumes of local anesthetic agents with no recorded complications.

scholarly journals Comparison of quadratus lumborum block and caudal block for postoperative analgesia in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries: a randomized controlled trial

2020 ◽  
Vol 45 (3) ◽  
pp. 187-191 ◽  
Author(s):  
Gözen Öksüz ◽  
Mahmut Arslan ◽  
Aykut Urfalıoğlu ◽  
Ahmet Gökhan Güler ◽  
Şeyma Tekşen ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Postoperative Analgesia ◽  
Pediatric Patients ◽  
Demographic Data ◽  
Parent Satisfaction ◽  
Caudal Block ◽  
Double Blind ◽  
Quadratus Lumborum

Background and objectivesCaudal epidural anesthesia is a widely used popular technique for postoperative analgesia but it has potential side effects and duration of analgesia is short. Quadratus lumborum block (QLB) was found to be an effective method for postoperative analgesia in lower abdominal surgeries. In this double-blind prospective randomized trial, we aimed to compare the postoperative analgesic efficacies of QLB and the caudal block in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries under general anesthesia.Materials and methodsAfter approval was obtained from the ethics committee, in this prospective randomized double-blind trial, 53 patients under general anesthesia undergoing inguinal hernia repair and orchiopexy surgeries randomly received caudal block or QLB. Demographic data, postoperative analgesic requirement, Face, Legs, Activity, Cry, and Consolability (FLACC) scores at 30 min, 1, 2, 4, 6, 12 and 24 hours, parent satisfaction scores and complications were recorded.ResultsThe study included 52 patients, after excluding one patient because of a failed caudal block. There were no significant differences between the groups based on demographic data (p>0.05). The number of patients who required analgesics in the first 24 hours was significantly lower in QLB group (p=0.001). Postoperative 4, 6, 12 hours FLACC scores were significantly lower in the QLB group (p<0.001, p=0.001 and p<0.001, respectively). Parent satisfaction scores were higher in the QLB group (p=0.014).ConclusionAccording to the results of this study, QLB can provide much more effective analgesia than caudal block without adjuvants in multimodal analgesia management of children undergoing inguinal hernia repair and orchiopexy surgeries.Trial registration numberNCT03294291.

scholarly journals Postoperative analgesia and opioid use following hip arthroscopy with ultrasound-guided quadratus lumborum block: a randomized controlled double-blind trial

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092099
Author(s):  
Liangjing Yuan ◽  
Ye Zhang ◽  
Chengshi Xu ◽  
Anshi Wu
Keyword(s):  
General Anesthesia ◽  
Hip Arthroscopy ◽  
Opioid Consumption ◽  
Hip Surgery ◽  
Opioid Use ◽  
Ultrasound Guided ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Vas Scores ◽  
Time Point

Objective To investigate the postoperative analgesic effect of ultrasound-guided quadratus lumborum block (QLB) in patients undergoing arthroscopic hip surgery. Methods Patients who were scheduled to undergo elective arthroscopic hip surgery were randomly assigned to the QLB (Q) or control (C) group (n = 40 each). After general anesthesia induction, unilateral QLB was performed under ultrasound guidance in the Q group. The amount of opioid use via patient-controlled analgesia (PCA) and the resting and movement pain visual analog scale (VAS) scores when the patient left the postanesthesia care unit (PACU) and 4, 8, 12, and 24 hours after surgery were recorded. Postoperative complications were recorded for both groups. Results At 24 hours post-surgery, opioid consumption amounts via PCA (48.4 [48.1–48.6] mL) in the Q group were significantly lower compared with the C group (52.0 [51.0–53.8] mL). A significant reduction in opioid consumption was observed between the two groups at each time point. Resting and movement VAS scores at each time point were significantly lower in the Q compared with the C group. Conclusions Hip arthroscopy patients who received QLB and general anesthesia in combination had less pain and a lower opioid requirement within 24 hours postoperatively.

scholarly journals Bilateral ultrasound-guided abdominal peripheral block in tap plane, tap - block

2020 ◽  
Vol 18 (4) ◽  
pp. 344-349
Author(s):  
M. Sekulovski ◽  
B. Simonska ◽  
G. Mutafov ◽  
V. Alexandrov ◽  
L. Spassov
Keyword(s):  
General Anesthesia ◽  
Analgesic Efficacy ◽  
Opioid Analgesics ◽  
Abdominal Muscle ◽  
Control Group ◽  
Tap Block ◽  
Ultrasound Guided ◽  
Group I ◽  
Group Ii ◽  
Peripheral Block

INTRODUCTION: Bilateral ultrasound-guided peripheral block (TAP - block) in the plane between the inner oblique abdominal muscle and the transversal abdominal muscle – TAP plane, is a regional anesthesia technique by infiltration of a local anesthetic, provides analgesia for operations involving the anterior abdominal wall. The analgesic effectiveness of the block decreases the consumption of opioid analgesics and non-steroidal anti-inflammatory drugs. AIM: In this study, we evaluated the intraoperative analgesic efficacy of bilateral TAP - block and the consumption of opioid analgesics in patients undergoing bilateral laparoscopic inguinal hernia repair. METHODS: The study was conducted with 35 patients, who were randomized into two groups. In the control group (group I), there are patients who received general anesthesia (GA), and experimental group (group II), were patients who have received general anesthesia and a bilateral tap block (GA + TAP). RESULTS: Patients with TAP-block (group II) have significantly lower fentanyl consumption compared to group I. CONCLUSION: Multimodal approach for the simultaneous administration of general anesthesia with a TAP block provides effective intraoperative analgesia and significantly reduces the perioperative consumption of opioid analgesics.

scholarly journals Evaluation of the efficacy of Granisetron over Droperidol in the prevention of Postoperative Nausea and Vomiting following open Cholecystectomy

JMS SKIMS ◽  
2011 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
Abdul Qayoom Lone ◽  
Shruti Sharma ◽  
Mohamad Ommid ◽  
Showkat H Nengroo ◽  
Imtiyaz Naqash
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Open Cholecystectomy ◽  
Randomized Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Physical Status ◽  
Double Blind ◽  
Post Operative Nausea ◽  
To Receive

BACKGROUND: Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. OBJECTIVE: To compare the efficacy of Granisetron over Droperidol in the prevention of PONV in patients undergoing elective open cholecystectomy under general anesthesia. MATERIAL & METHODS: In this double blind randomized study, 100 adult patients with physical status ASA I and II, (age, 20-60 years), were randomly allocated into two groups, X or Y, to receive either injection Granisetron hydrochloride (3 mg i/v) or Droperidol (2.5 mg i/v), 5 min prior to induction of general anesthesia. The incidence of nausea and vomiting was recorded every six hourly for a period of 24 hour after the surgery. RESULTS: 6 (12%) patients in the granisetron group and 20 (40%) patients in the Droperidol group reported an emetic episode, (p = 0.002); the incidence of PONV in the total 24 hr period after the surgery, 54% in the granisetron group and 76% in Droperidol group (p = 0.022) CONCLUSIONS: It was found that granisetron is superior to Droperidol in the prevention of postoperative nausea and vomiting. JMS 2011;14(1):11-14

scholarly journals Comparison of Ultrasound Guided Transversus Abdominis Plane Block Versus Local Wound Infiltration for Post Operative Analgesia in Patients Undergoing Gynaecological Surgery Under General Anaesthesia

2015 ◽  
Vol 12 (2) ◽  
pp. 93-96 ◽  
Author(s):  
S Ranjit ◽  
SK Shrestha
Keyword(s):  
Analgesic Efficacy ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Control Group ◽  
Block Group ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Chi Square ◽  
Wound Infiltration ◽  
Pfannenstiel Incision

Background Transversus abdominis plane block has been recently developed as a part of multimodal post operative analgesic techniques. We compared the analgesic efficacy of this technique with local bupivacaine infiltration in patients undergoing gynaecological surgeries with pfannenstiel incision and lower midline incision under general anaesthesia.Objectives To evaluate the efficacy of ultrasound guided transversus abdominis plane block for postoperative analgesia.Methods Patients were randomly allocated to three groups: control group (n=15), transversus abdominis plane block group (n=15), who received bilateral transversus abdominis plane blockwith 0.25% bupivacaine, and local infiltration group (n=15), who received local wound infiltration with 0.25% bupivacaine at the end of surgery. All patients received intramuscular diclofenac 12 hourly and intravenous tramadol SOS in the postoperative period. Visual analogue scores for pain were assessed at 1,2,4,8,12 and 24 hours postoperatively and these were compared between the three groups. Average tramadol consumption in 24 hours were also compared among the three groups. Data were subjected to univariate ANOVA test and chi-square test. Level of significance was set at 0.05.Results Visual analogue scores were significantly less in transversus abdominis plane block group and effect lasted up to 12 hours at rest postoperatively and 8 hours during cough and movement.Conclusion Bilateral Transversus abdominis plane block was effective in reducing postoperative pain scores for 8 to 12 hours postoperatively. This block was also successful in reducing postoperative opioid requirement.Kathmandu University Medical Journal Vol.12(2) 2014: 93-96

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