Analgesia in Children Using Caudal Epidural Ropivacaine

Study Overview
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Brief Summary
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Caudal epidural analgesia (caudal block)is used in standard pediatric anesthesia practice. It has been shown to be effective in managing postoperative pain in children undergoing abdominal and infraumbilical surgery (Tobias et al 1994). Furthermore, studies have shown that children receiving caudal blocks have secondary benefits such as lower narcotic and anesthetic requirements, more rapid awakening from general anesthesia, decreased time to discharge home, and fewer pain-related behaviors postoperatively (Conroy et al 1993, Tobias et al 1995, Tobias 1996). This proposed study involves the use of a caudal block in children undergoing elective inguinal herniorrhaphy or orchiopexy to evaluate the role of preemptive analgesia in pediatric pain management. We hypothesize that by inhibiting peripheral pain receptors with a caudal block before the onset of a painful stimulus, we can decrease central nervous system sensitization and reduce postoperative analgesic requirements

Official Title
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Preemptive Analgesia in Children Using Caudal Epidural Ropivacaine: A Prospective, Randomized, Double-blinded, Controlled Study

Conditions
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Inguinal Hernia, Circumcision

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 2 months to 2 years Weight 25kg or less ASA class 1, 2, 3 Elective inguinal herniorrhaphy or orchiopexy Exclusion Criteria: Contraindications to caudal epidural analgesia parent's refusal skeletal or spinal cord anomaly coagulopathy infection at the insertion site ongoing bacteremia allergy to ropivacaine

Ages Eligible for Study
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Minimum Age: 2 Months
Maximum Age: 2 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group CB (Caudal Before-study group)<br>This group will receive caudal ropivacaine and epinephrine after induction of general anesthesia prior to surgical incision | |
| Caudal After (CA)-control group<br>This group will receive caudal ropivacaine with epinephrine after completion of surgery but before emergence from anesthesia | |
| Local Infiltration After (LIA) control group<br>This group will receive local infiltration of ropivacaine around the surgery site at the conclusion of surgery but before emergence from anesthesia | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Usage of pain medications |  | over 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain scores |  | At various intervals for first 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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caudal epidural analgesia, elective circumcision, elective inguinal herniorrhaphy