Pediatric Caudal Anesthesia Block. And Pain Control
Condition: Pain, Postoperative; Adverse Reaction to Epidural Anesthesia; Anesthesia, Caudal
MeSH terms: Pain, Postoperative
Study type: Observational [Patient Registry]

Summary: 
      Caudal epidural block CEB is the most commonly performed neuraxial block to provide effective
      pain relief and analgesia in patients undergoing infra-umbilical pediatric surgery. This
      study aimed to compare the effectiveness of adding CEB to general anesthesia in terms of
      intra- and post-operative pain management. Design: Double-unblinded.

      Prospective. randomized. Study, Setting: salmanyia medical complex. intraoperative,
      postoperative recovery room Methods: A total of 72 patients American Society of
      Anesthesiology physical status classification ASA 1. Patients were equally allocated into two
      groups Group A and with CEB and Group B without CEB, aged two months to six years.
      respectively, over a study period of six months. Both groups were compared based on
      hemodynamic stability, level of sedation, analgesia need, pain score, and parental
      satisfaction. Postoperative pain was evaluated by four different pain scales.
    

Detailed description: 
      the data collection uses a combination of quantitative and qualitative data. Quantitative
      Data: These include numerical datasets, which can be analyzed with mathematical techniques
      and are collected based on scales such as numbers of patients with or without CEB, interval,
      ratio, and ordinal. Resultantly, then the data are surveys and questionnaires, observations
      of hemodynamics, and behaviors. and data pain scores are collected inside the recovery room
      and based on the Children's Hospital Eastern Ontario Pain Scale (CHEOPS), Faces Pain
      Scale-Revised (FPS-R), and Face, Legs, Activity, Cry CONSOL ability (FLACC) scales. That data
      was collected through four phases, pre-op Intra op and post-op 1 hour in PACU, and six hours
      post-op was observed by the nurses in the ward. the data is divided into primary and
      secondary. the primary data were directly collected from the parents and information on the
      medical history from the files in the hospital was recorded, and the secondary data was
      collected directly by the anesthesiologist inside the operation room Once the patient was
      shifted to the operating theatre, the patient's age, sex, weight, height, types of surgeries
      will be performed, and the type of GA induction and maintenance agents were recorded in the
      anesthesia charts then in the recovery room, patients, pain scores, and behaviors are
      monitored according to the regular in the organization, then in the ward are based on
      questionnaires, observations and comparing the statically significant value between the two
      groups. The raw data which was collected from case report forms were entered into a Microsoft
      Excel Spreadsheet initially. Then, the data have been transferred to and analyzed by IBM SPSS
      Statistics software version 21. The categorical and numerical variables of both groups were
      analyzed and compared. Data are expressed as n (%), mean ± standard deviation or median and
      interquartile range (IQR) according to distribution normality. Continuous variables were
      compared using the Mann-Whitney U test, and categorical variables were compared using
      Fisher's exact test or Pearson Chi-square test. The confidence interval was set at 95%.
    

Intervention name(s): Group A Caudal Epidural Anesthesia with bupivacaine 0.25% and group B with opioid intervenors
Intervention type(s): Combination Product
Intervention description(s): (CEB) in group A using drugs bupivacaine 0.25% commonly used in children including neonates in group A In infraumbilical operations, it is used as a supplement to GA and to control postoperative pain It is a safe, easy, and effective type of central neuraxial block.[ The patient will be intubated and the caudal block will be performed under GA after securing the airway. The patient's position will be turned onto the lateral decubitus then a landmark-based, blind technique will be used. In children, the success rate with the blind technique is above 96% but the occurrence of side effects is reported. Group B uses general anesthesia (GA) alone for intraoperative and perioperative pain control used the opioid intervious without caudal block .
Other intervention name(s): Regional anesthesia intervention and pain control
Intervention MeSH terms: Bupivacaine; Anesthetics
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        CONsolidated Standards of Reporting Trials (CONSORT) checklist was used for enrolment and
        allocation of patients. Children aged between two months and six years who were undergoing
        infra-umbilical surgeries with ASA PS I were randomly allocated to either group A (GA with
        CEB) or to group B (GA without CEB).,
      
Keywords: caudal; Pain Management; Anesthesia; pediatric