NCT04292782

Quadratus Lumborum Block for Pediatric Hip Surgery

Caudal Epidural Block Compared to Anterior Quadratus Lumborum Block for Pediatric Hip Surgery

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 40 (actual)
• Sponsor: University Tunis El Manar · Academic / Other
• Sex: All
• Age: 2 Years – 7 Years
• Healthy volunteers: Not accepted

Summary

Caudal blockade (CB) is one of the most frequently performed regional anaesthetic techniques in children. It's an efficient way to offer perioperative analgesia for painful sub-umbilical interventions but with high incidence of motor block and urinary retention. In one study, psoas compartment block was associated with less morphine comsumption and prolonged duration of analgesia compared to single-shot caudal Block in small children undergoing open hip reduction/osteotomies. Ultasound guided anterior Quadratus lumborum block (AQLB) provides unilateral analgesia to the nerves between the psoas muscle (PM) and the quadratus lumborum muscle (QLM). The first pediatric study evaluating Quadratus lumborum block is encouraging . The first pediatric study evaluating Quadratus lumborum block is encouraging. To the best of the investigator's knowledge, there are no previously published data comparing the AQLB with other regional techniques in infants undergoing hip surgery.

Detailed description

The aim of this prospective randomized study was to compare the analgesic effects between AQLB and CB in children undergoing unilateral open hip reduction/osteotomies for hip dislocation. Patients were randomly assigned, into 1 of 2 groups, namely, group CB (n = 20) and group AQLB (n = 20). Preoperatively all children were premedicated by using oral midazolam (0 .5mg/kg). anesthesia was induced with 3 to 4% sevoflurane and 50% with 60% nitrous oxide in oxygen.Then fentanyl 3 μg/kg and Propofol 1 - 2mg/Kg were administered for anesthesia induction. Airway was secured with endotracheal tube placed in the mouth facilited by 0.15 mg/kg cistracurium. Anesthesia maintenance was performed with sevoflurane 2% in 50% nitrous oxide. AQLB and CB were done with 1 ml/kg, 0.25% Ropivacaine (maximum dose limited to 20 ml) Postoperative follow-up: All patients received 15 mg/kg paracetamol before extubation. Tramadol 2 mg/kg intravenous was planned as rescue analgesia when CHEOPS score was more than 3. Supplemental IV tramado, 1 mg/kg could be added if necessary every 6 hours.

Conditions

• Hip Dislocation, Congenital
• Postoperative Pain
• Anesthesia

Interventions

Type	Name	Description
PROCEDURE	anterior Quadratus lumborum block	ultrasound anterior quadratum lumborum block with 1 ml/kg 0.2% ropivacaine
PROCEDURE	caudal block	ultrasound guided caudal block with 1 ml/kg 0.2% ropivacaine

Timeline

• Start date: 2020-03-31
• Primary completion: 2021-03-30
• Completion: 2021-12-31
• First posted: 2020-03-03
• Last updated: 2024-02-13

Locations

1 site across 1 country: Tunisia