Continuous Erector Spinae Block for Post Analgesia in Pediatric Patients

Study Overview
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Brief Summary
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The aim of this study is to evaluate the analgesic efficacy of erector spinae plane block in pediatric cancer patients undergoing open nephrectomy

Detailed Description
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Sixty patients will be included in this prospective randomized study. The patients will be allocated into two groups: the ESPB group (group E, n = 30) and the tramal group (group T, n =30). All patients will receive standard general anesthesia. Ultrasound-guided ESPB will be performed to group erector spinae plane block

Official Title
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Continuous Erector Spinae Plane Local Anesthetic Infusion for Postoperative Analgesia in Pediatric Patients Undergoing Nephrectomy: Randomized Controlled Study

Conditions
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Pediatric Cancer

Intervention / Treatment
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* Drug: Bupivacaine Hydrochloride
* Drug: Tramadol hydrochloride


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Physical status ASA II. Patients (age 2-7yrs) scheduled for open nephrectomy for malignant kidney tumors Exclusion Criteria: History of psychological disorders. Known sensitivity or contraindication to local anesthetics. Localized infection at the site of block. patients with coagulopathy or an (INR ≥ 2)

Ages Eligible for Study
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Minimum Age: 2 Years
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
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Erector spinae group<br>patient will be placed in a sitting position under complete aseptic condition and a cover sheath will be used for the ultrasound probe with an appropriate amount of lubricating gel applied on the probe, a high-frequency linear ultrasound transducer will be placed in a longitudinal orientation 3 cm lateral to the L3 spinous process. This should reveal three muscles superficial to the hyperechoic transverse process shadow as follows: trapezius, rhomboid major, and erector spinae. | Drug: Bupivacaine Hydrochloride<br>* The patient will be placed in a sitting position under complete aseptic condition and a cover sheath will be used for the ultrasound probe with an appropriate amount of lubricating gel applied on the probe, a high-frequency linear ultrasound transducer will be placed in a longitudinal orientation 3 cm lateral to the L3 spinous process. This should reveal three muscles superficial to the hyperechoic transverse process shadow as follows: trapezius, rhomboid major, and erector spinae. then injecte bupivacaine hydrochloride<br>* Other names: erector spinae block;|
| Placebo Comparator: Opioid GROUP<br>Patient in group T will intravenously administrate dose of 1 mg/kg/8hr tramal ( opioid) to be increased upon patient needs up to 2mg/kg/6hr as rescue analgesic. | Drug: Tramadol hydrochloride<br>* Patients in group Tramadol will intravenously administrate dose of 1 mg/kg/8hr tramal to be increased upon patient needs up to 2mg/kg/6hr as rescue analgesic<br>* Other names: opioid group;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total amount of opioid consumption in milligram | total amount of opioid consumption in the frist 48hours postoperative | 48 hours |