Dorsal Nerve Block and Caudal Block in Hypospedius Repair in Children

NCT ID: NCT06500286

Last Updated: 2024-07-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE1

Total Enrollment

103 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-31

Study Completion Date

2025-03-31

Brief Summary

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Comparison between Dorsal nerve block and caudal block effect in post operative pain in hypospedius repair in children Randomoized clinical trial

Detailed Description

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• Group A receive caudal block placing the patient into the left lateral decubitus position. Povidone iodine was used to sterilize the skin. The sacral hiatus was found by palpating the sacral cornu and a 22-G needle was placed through it. After passing through the sacrococcygeal membrane by using the loss of resistance method, the caudal epidural space was entered. Negative aspiration was used to make sure there was no blood or cerebrospinal fluid present and 0.25% bupivacaine was administered at a dose of 0.2 ml/kg. Once the procedure was completed, the patient was placed into the supine Position.

Group B US guided Dorsal penil block. General anesthesia induction was followed by skin sterilization using 70% alcohol in 2% chlorhexidine. The 5-10 MHz linear probe was placed at the penis root, making it possible to observe the corpus cavernosum, corpus spongiosum, dorsal artery and vein, and the deep penile fascia (Buck's fascia) on the transverse plane with gentle penile traction. The in-plane technique was then used to insert a 50-mm block needle toward the dorsal penile section from the lateral part of the penis root. The needle was then advanced from the hyperechoic superficial penis fascia (Dartos fascia) and the superficial sheath was passed. After advancing the needle into Buck's fascia, the needle was placed lateral to the dorsal artery, at a position between Buck's fascia and tunica albuginea. Negative aspiration was performed. US was then used to observe the distribution of the anesthetic while half of the total 0.25% bupivacaine dose (0.2 mL/kg) was administered (Fig. 1). Afterward, the same procedure was also performed on the other side of the penis.

Conditions

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Dorsal Nerve Block in Hypospiudus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Group A

• Group A receive caudal block placing the patient into the left lateral decubitus position. . The sacral hiatus was found by palpating the sacral cornu and a 22-G needle was placed through it. After passing through the sacrococcygeal 0.25% bupivacaine was administered at a dose of 0.2 ml/kg.the procedure was completed, the patient was placed into the supine Position.

Group Type EXPERIMENTAL

Marciane

Intervention Type DRUG

Group A caudal block 0.25% bupivacaine was administered at a dose of 0.2 ml/k

Group B

Group B US guided Dorsal penil block. The 5-10 MHz linear probe was placed at the penis root, making it possible to observe the corpus cavernosum, corpus spongiosum, dorsal artery and vein, and the deep penile fascia (Buck's fascia) on the transverse plane with gentle penile traction. The in-plane technique was then used to insert a 50-mm block needle toward the dorsal penile section from the lateral part of the penis root. The needle was then advanced from the hyperechoic superficial penis fascia (Dartos fascia) and the superficial sheath was passed. After advancing the needle into Buck's fascia, the needle was placed lateral to the dorsal artery, at a position between Buck's fascia and tunica albuginea. Negative aspiration was performed. US was then used to observe the distribution of the anesthetic while half of the total 0.25% bupivacaine dose (0.2 mL/kg) was administered (Fig. 1). Afterward, the same procedure was also performed on the other side of the penis.

Group Type EXPERIMENTAL

Marcaine

Intervention Type DRUG

Dorsal penil block 0.25% bupivacaine was administered at a dose of 0.2 ml/k

Interventions

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Marciane

Group A caudal block 0.25% bupivacaine was administered at a dose of 0.2 ml/k

Intervention Type DRUG

Marcaine

Dorsal penil block 0.25% bupivacaine was administered at a dose of 0.2 ml/k

Intervention Type DRUG

Other Intervention Names

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bupivacaine bupivacaine

Eligibility Criteria

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Inclusion Criteria

* aged 2-12 years
* ASA physical status I or II

Exclusion Criteria

* asthmatic patients
* emergency surgery
* intellectual disability
* neurological diseases with agitation-like symptoms
* renal or hepatic disease,
* cardiac or respiratory disease
* allergy to the study drugs
* parent refusal
* psychiatric diseases
Minimum Eligible Age

2 Years

Maximum Eligible Age

12 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Soha Abd Elhamid Fawzy

Resident doctor in assiut university hospitals

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Soha Abdelhamid Fawzy, Resident

Role: PRINCIPAL_INVESTIGATOR

Resident

Central Contacts

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Soha Abdelhamid Fawzy, Resident

Role: CONTACT

01061424208

Mohammed Sayed abdelal, Assistant

Role: CONTACT

01001204222

References

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Baskin LS, Lee YT, Cunha GR. Neuroanatomical ontogeny of the human fetal penis. Br J Urol. 1997 Apr;79(4):628-40. doi: 10.1046/j.1464-410x.1997.00119.x.

Reference Type RESULT
PMID: 9126098 (View on PubMed)

Ngoo A, Borzi P, McBride CA, Patel B. Penile nerve block predicts higher revision surgery rate following distal hypospadias repair when compared with caudal epidural block: A consecutive cohort study. J Pediatr Urol. 2020 Aug;16(4):439.e1-439.e6. doi: 10.1016/j.jpurol.2020.05.150. Epub 2020 Jun 6.

Reference Type RESULT
PMID: 32636118 (View on PubMed)

Hueber PA, Salgado Diaz M, Chaussy Y, Franc-Guimond J, Barrieras D, Houle AM. Long-term functional outcomes after penoscrotal hypospadias repair: A retrospective comparative study of proximal TIP, Onlay, and Duckett. J Pediatr Urol. 2016 Aug;12(4):198.e1-6. doi: 10.1016/j.jpurol.2016.04.034. Epub 2016 Jun 2.

Reference Type RESULT
PMID: 27318548 (View on PubMed)

Spinoit AF, Poelaert F, Van Praet C, Groen LA, Van Laecke E, Hoebeke P. Grade of hypospadias is the only factor predicting for re-intervention after primary hypospadias repair: a multivariate analysis from a cohort of 474 patients. J Pediatr Urol. 2015 Apr;11(2):70.e1-6. doi: 10.1016/j.jpurol.2014.11.014. Epub 2015 Feb 26.

Reference Type RESULT
PMID: 25797860 (View on PubMed)

Other Identifiers

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Dorsal block in hypospedius

Identifier Type: -

Identifier Source: org_study_id

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