학술논문
Comparison of the analgesic efficacy of ultrasound-guided rectus sheath block and local anesthetic infiltration for laparoscopic percutaneous extraperitoneal closure in children.
Document Type
Article
Author
Source
Subject
*ANALGESICS
*ULTRASONIC imaging
*ANESTHETICS
*LAPAROSCOPIC surgery
*POSTOPERATIVE care
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Language
ISSN
1155-5645
Abstract
Background Ultrasound-guided rectus sheath block and local anesthetic infiltration are the standard options to improve postoperative pain for children undergoing surgery with a midline incision. However, there is no study comparing the effect of ultrasound-guided rectus sheath block with local anesthetic infiltration for children undergoing laparoscopic surgery. Aims The aim of this trial was to compare the onset of ultrasound-guided rectus sheath block with that of local anesthetic infiltration for laparoscopic percutaneous extraperitoneal closure in children. Methods We performed an observer-blinded, randomized, prospective trial. Enrolled patients were assigned to either an ultrasound-guided rectus sheath block group or a local anesthetic infiltration group. The ultrasound-guided rectus sheath block group ( n = 17) received ultrasound-guided rectus sheath block with 0.2 ml·kg−1 of 0.375% ropivacaine per side in the posterior rectus sheath compartment. The local anesthetic infiltration group ( n = 17) received local anesthetic infiltration with 0.2 ml·kg−1 of 0.75% ropivacaine. The Face, Legs, Activity, Cry, and Consolability ( FLACC) pain scores were recorded at 0, 30, 60 min after arrival at the postanesthesia care unit. Results Of the 37 patients enrolled in this study, 34 completed the study protocol. A significant difference in the pain scale between the ultrasound-guided rectus sheath block group and local anesthetic infiltration group was found at 0 min (median: 0, interquartile range [ IQR]: 0-1.5, vs median: 1, IQR 0-5, confidence interval of median [95% CI]: 0-3, P = 0.048), but no significant difference was found at 30 min (median: 1, IQR: 0-4 vs median: 6, IQR: 0-7, 95% CI: 0-5, P = 0.061), or 60 min (median: 0, IQR: 0-2 vs median: 1, IQR: 0-3, 95% CI: −1 to 1, P = 0.310). No significant difference was found in anesthesia time between the ultrasound-guided rectus sheath block and local anesthetic infiltration groups. No procedure-related complications were observed in either group. Conclusion Ultrasound-guided rectus sheath block is a quicker way to control postoperative pain for pediatric patients undergoing laparoscopic extraperitoneal closure than local anesthetic infiltration, and thus may provide a clinical benefit. [ABSTRACT FROM AUTHOR]