A randomised study comparing the extent of block produced by spinal column height and body weight-based formulae for paediatric caudal analgesia

Kaushal, Sonali; Singh, Surinder; Sharma, Anupam

doi:10.4103/ija.ija_824_19

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Using minimum required dose, concentration and volume of local anaesthetic is desirable to prevent such subclinical or clinical complications. [ 4 17 ] Performing a nerve block under ultrasound guidance may help reduce volume used through better localisation. [ 18 19 ] The duration of continuous nerve blocks can be increased by other options (e.g., combination with other drugs etc.)…”

Section: Discussionmentioning

confidence: 99%

Measurement of bupivacaine induced myotoxicity in interfascial plane blocks: A randomised controlled trial

Kaushal¹,

Rakhi²,

Singh³

2021

Indian Journal of Anaesthesia

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Background and Aims: Recent reports of local-anaesthetic induced myotoxicity after peripheral nerve blocks have increased interest in this less commonly known complication. Although the morphological, physiological and biochemical changes in muscle after injection of clinically used concentration of bupivacaine have been studied in animals, little research has been conducted on human subjects, especially in relation to fascial plane blocks. We conducted a study to examine the changes in circulating creatine phosphokinase (CPK) levels in patients undergoing modified radical mastectomy (MRM) or mesh hernioplasty (MH) with or without peripheral nerve blocks. The study explored local anaesthetic (bupivacaine) induced myotoxicity by measuring changes in serum CPK levels following transversus abdominis plane block (TAP) or pectoral nerve block-II (PEC- II) in patients undergoing MH or MRM, respectively. Methods: The study was a randomised, controlled open-label trial. Patients undergoing MH who were randomised to the intervention group received TAP block whereas those undergoing MRM received PEC-II block. Blood samples were drawn at baseline, 6 and 24 hours after surgery for serum CPK measurements. Changes in serum CPK levels between the control and intervention groups were compared using repeated-measures analysis of variance. Results: Baseline serum CPK levels were similar between the groups. There was a significant difference in the change in serum CPK levels between the groups. It significantly rose in the intervention group as compared to the control group (p < 0.001). Conclusion: The study shows that serum CPK levels significantly increase at 24 hours after interfascial plane block thereby indirectly indicating myotoxicity. Further research is needed to ascertain its clinical impact.

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Section: Discussionmentioning

confidence: 99%

Measurement of bupivacaine induced myotoxicity in interfascial plane blocks: A randomised controlled trial

Kaushal¹,

Rakhi²,

Singh³

2021

Indian Journal of Anaesthesia

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“…The most commonly chosen techniques are dorsal penile nerve (DPN) and caudal blocks [4]. A caudal block is an effective method for anesthesia and postoperative analgesia in pediatric surgery [5]. But, as a neuraxial block, it has the potential for more severe complications than those related to peripheral nerve block [6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Postoperative Analgesic Effect of 2 Different Blocks after Pediatric Circumcision Surgery

Mutlu¹,

Türkmen²

2021

Urol Int

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Background: Circumcision is a painful day-case surgery. Regional anesthesia techniques are used effectively for anesthesia and postoperative analgesia after pediatric circumcision surgery. Objective: Our prospective observational study aimed to compare postoperative analgesic efficiency of a dorsal penile nerve (DPN) block with a transversus abdominis plane (TAP) block after male pediatric circumcision surgery and complications related to each block. Study Design: We enrolled 80 male children under the age of 10 years with American Society of Anesthesiologists I–II status scheduled for circumcision in this prospective observational study. A TAP or DPN block was performed after induction of general anesthesia before surgery with ultrasound (US) guidance. Postoperative pain was assessed with Faces Pain Scale-Revised and the Faces, Legs, Activity, Cry and Consolability scale. Results: There was no statistically significant difference between the groups regarding 30-min pain score levels (p > 0.05). But, the 1st hour, 2nd hour, 6th hour, 12th hour, and 24th-hour pain score levels in the TAP block group were statistically significantly higher than those of the DPN block group (p < 0.05). The 1st rescue analgesic requirement in the TAP block group was at the 6th hour postoperative. There was no need for rescue analgesia in the DPN block group during the postoperative 24-h follow-up. Discussion: A US-guided DPN block provided effective and long-lasting postoperative analgesia for circumcision surgery with statistically significantly lower pain score levels than a US-guided TAP block. Conclusion: This study found that a TAP block alone was insufficient to provide adequate postoperative analgesia for circumcision surgery compared to DPN block.

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Comparison of ultrasound-guided transversus abdominis plane block and caudal epidural block for postoperative analgesia in paediatric lower abdominal surgeries: A randomised controlled trial

Ranjan

Singh

2023

Indian Journal of Anaesthesia

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Background and Aims: Ultrasound-guided transversus abdominis plane (TAP) block is an effective technique for postoperative analgesia in lower abdominal surgeries. This study aims to compare the duration and efficacy of an ultrasound-guided TAP block with those of a caudal epidural for paediatric unilateral lower abdominal surgeries. Methods: After ethical approval, sixty children aged 1 to 9 years were randomised into ultrasound-guided TAP block or caudal block with general anaesthesia for unilateral lower abdominal surgeries. The primary endpoint was time for the first rescue analgesia in the postoperative period. The secondary endpoints were total postoperative opioid consumption, modified Children Hospital of Eastern Ontario Pain Scale (CHEOPS) and the Face, Legs, Activity, Cry and Consolability (FLACC) scale in the postoperative period. Results: The mean time for first rescue analgesia was 11.33 ± 2.80 h in the TAP block group, while in the caudal group, it was 13.18 ± 2.67 h (95% confidence interval [CI] mean difference 2.58–10.58, P = 0.017). The total postoperative morphine requirement was comparable in both groups at both 12 h (TAP block group 0.50 ± 0.12 mg vs. caudal block group 0.56 ± 0.12 mg, 95% CI mean difference 0.09–0.02, P = 0.08) and 24 h (TAP block group 0.96 ± 0.30 mg vs. caudal block group 0.81 ± 0.34 mg, 95% CI mean difference 0.06–0.32, P = 0.06) time period. Conclusion: The mean time for first rescue analgesia was lesser in the TAP block group as compared to caudal group.

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A randomised study comparing the extent of block produced by spinal column height and body weight-based formulae for paediatric caudal analgesia

Cited by 4 publications

References 23 publications

Measurement of bupivacaine induced myotoxicity in interfascial plane blocks: A randomised controlled trial

Measurement of bupivacaine induced myotoxicity in interfascial plane blocks: A randomised controlled trial

Evaluation of the Postoperative Analgesic Effect of 2 Different Blocks after Pediatric Circumcision Surgery

Comparison of ultrasound-guided transversus abdominis plane block and caudal epidural block for postoperative analgesia in paediatric lower abdominal surgeries: A randomised controlled trial

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