Popliteal Block for Postoperative Pain in Knee-ankle Soft Tissue Surgery in Cerebral Palsy

Study Overview
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Brief Summary
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Popliteal block is a technique for providing postoperative pain management in children. In this randomized double-blinded study, the investigators evaluated the effects of preoperative popliteal nerve block on postoperative pain and analgesic requirement in children with cerebral palsy (CP) undergoing knee-anckle soft tissue surgery. The Wong Baker faces scale and skin conductance fluctuations will be assessed.

Detailed Description
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Sevoflurane will be used for anesthesia induction and maintance. Laryngeal mask airway will be placed without neuromuscular blocking agent. In group P (popliteal block), a single dose of 0.3ml.kg(-1) of 0.25% bupivacaine will be performed for popiteal nerve block (with ultrasound guidence). In group C ( control), only plaster cover will be applied without nerve block for sham procedure to provide double-blinded study. Intraoperative heart rate, mean arterial pressure, BIS (bispectral index) values, sevoflurane consumption will be recorded ten minutes interval. Wong Baker faces scale and skin conductance fluctuations will be recorded at postoperative 0, 10th min, 20th min , 1st h, 4th h, 12th h qnd 24th h. Total analgesic consumption (paracetamol orally ) will be recorded.

Official Title
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Popliteal Block for Postoperative Pain in Knee-ankle Soft Tissue Surgery in Cerebral Palsy

Conditions
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Postoperative Pain, Cerebral Palsy

Intervention / Treatment
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* Procedure: Popliteal block
* Drug: Sevoflurane
* Device: Ultrasound
* Other: Plaster cover
* Drug: bupivacaine
* Other: Laryngeal mask airway


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children with cerebral palsy Scheduled for knee and ankle surgery Exclusion Criteria: Autonomic neuropathy Medication with anticholinergic drugs Continuous infusion of vasoactive drugs

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: popliteal block<br>Popliteal block will be performed with a single dose of 0.3 ml·kg(-1) of 0.25% bupivacaine. | Procedure: Popliteal block<br>* In group P, popliteal block will be performed with ultrasound guidence.<br>Drug: Sevoflurane<br>* Sevoflurane will be used to all patient's for anesthesia induction and maintenance<br>Device: Ultrasound<br>* For recognize the nerve (sciatic nerve), ultrasound will be used in group P.<br>Drug: bupivacaine<br>* Bupivacaine 0.25% will be performed for popliteal block to group P.<br>Other: Laryngeal mask airway<br>* After anesthesia induction, laryngeal mask airway will be inserted to all patients<br>|
| Sham Comparator: Plaster cover<br>Only plaster cover will be applied without nerve block for sham procedure. | Drug: Sevoflurane<br>* Sevoflurane will be used to all patient's for anesthesia induction and maintenance<br>Other: Plaster cover<br>* Plaster cover will be used to control group for sham procedure<br>Other: Laryngeal mask airway<br>* After anesthesia induction, laryngeal mask airway will be inserted to all patients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain assessment via Wong Baker faces scale |  | The patients will be followed up to 24 hours | 
| The number of fluctuations of skin conductance per second (NFSC). |  | The patients will be followed up to 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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nerve block