Ultrasound Guided Posterior Versus Lateral Transversus Abdominis Plan Block for Prolonged Postoperative Analgesic Effect in Children

Study Overview
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Brief Summary
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Ultrasound Guided Posterior Versus Lateral Transversus Abdominis Plan Block for Prolonged Postoperative Analgesic Effect in Children

Detailed Description
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the investigators will compare the effect of posterior Transversus abdominis plan block versus the effect of lateral transversus abdominis plan bock regarding the duration of analgesia and patients satisfaction the study will be conducted on 69 children aged from 1 to 7 years presented for lower abdominal surgery.

Official Title
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Ultrasound Guided Posterior Versus Lateral Transversus Abdominis Plan Block for Prolonged Postoperative Analgesic Effect in Children . Randomized Controlled Trial

Conditions
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Pain, Postoperative

Intervention / Treatment
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* Procedure: postoperative analgesia for lower abdominal surgery in children


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children from 1- 7 years scheduled to undergo lower abdominal surgery Exclusion Criteria: bleeding disorders emergency surgery skin lesion at site of needle insertion

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 7 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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: randomized control study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: lateral transversus abdominis block<br>patients will take lateral transversus abdominis plan block. The block will be done unilaterally on the same side of proposed surery with 0.25% bupivacaine at a volume of 1 ml·kg-1 | Procedure: postoperative analgesia for lower abdominal surgery in children<br>* compare lateral and posterior approaches of trannsversus abdominis plane block for analgesia after lower abdominal surgery in children<br>|
| Active Comparator: posterior tansversus abodominis plane block<br>patients will take posterior transversus abdominis plane block. The block will be done unilaterally on the same side of proposed surery with 0.25% bupivacaine at a volume of 1 ml·kg-1 | Procedure: postoperative analgesia for lower abdominal surgery in children<br>* compare lateral and posterior approaches of trannsversus abdominis plane block for analgesia after lower abdominal surgery in children<br>|
| Active Comparator: convential analgesia<br>conventional analgesia in form of 1 micrograms. Kg-1 fentanyl and paracetamol 15 mg. Kg-1 suppositories | Procedure: postoperative analgesia for lower abdominal surgery in children<br>* compare lateral and posterior approaches of trannsversus abdominis plane block for analgesia after lower abdominal surgery in children<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative pain assessment by the CHEOPS score | Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) for Post-Op Pediatric Pain the score is based on 6 crtiteria: crying facial expression child verbal expression body positiion touching or grabbing at wound legs position criterion 1 is given a score of 1-3, criterion 2 and 3 are given score 0-2, criterion 4,5 and 6 are given a score 1-2 making the worst possible score 13 while the least possible score is 4. a total score of 6 or less indicates adequate analgesia | the first 24 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| heart rate | Measurement of heart rate (beats per minute) | at 2,4,8,12 and 24 hours postoperative | 
| Mean arterial blood pressure | Measurement of Mean arterial blood pressure ( mm Hg) | at 2,4,8,12 and 24 hours postoperative |