Ultrasound Guided Serratus Anterior Plane Block Versus Thoracic Erector Spinae Plane Block for Post Operative Analgesia in Pediatrics Undergoing Thoracotomy

NCT ID: NCT06862518

Last Updated: 2025-03-06

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 105 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-07-01
• Study Completion Date: 2024-07-01

Brief Summary

This study is designed to compare the post operative analgesic effect of serratus anterior plane block versus thoracic erector spinae plane block in pediatrics undergoing thoracotomy

Detailed Description

The incidence of diseases that requires thoracotomy is low in the pediatric age group. Thoracotomy is a severe burden on children and is widely known to cause severe acute pain. This pain can be very distressing for both children and their parents. If not treated properly, it may acutely cause retention of secretion, atelectasis, ventilation-perfusion disorder and hypoxemia, together with a change in lung mechanics.

The serratus anterior plane block (SAPB) has also recently become more popular options for post-thoracotomy analgesia. SAPB involves local anesthetic injection in a plane superficial or deep to the serratus anterior muscle; in both these locations, it blocks the lateral cutaneous branches of intercostal nerves.

The erector spinae plane block (ESPB) is an ultrasound-guided deep plane interfascial block defined by Forero in 2016. It has been shown to provide thoracic and abdominal analgesia. When injected at the T5 transverse process level, the local anesthetic spreads anteriorly through the thoracolumbar fascia and reaches the ventral and dorsal rami of the spinal nerves and posteriorly to the gray and white rami communicantes of the sympathetic chain, providing a C7 to T8 sensitive block. Although it was first described as a chronic pain block, there are increasingly reports about its use in postoperative acute pain.

Conditions

Ultrasound; Serratus Anterior Plane Block; Thoracic Erector Spinae Plane Block; Post Operative Analgesia; Pediatrics; Thoracotomy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Control group

Patients will receive general anesthesia alone

Group Type: ACTIVE_COMPARATOR

Control group

Intervention Type: DRUG

Patients will receive general anesthesia alone

Serratus Anterior Plane Block (SAPB) group

Patients will receive general anesthesia (GA) with ultrasound guided serratus anterior plane block 0.5 ml/kg 0.25% bupivacaine.

Group Type: EXPERIMENTAL

Serratus Anterior Plane Block (SAPB) group

Intervention Type: DRUG

Patients will receive general anesthesia (GA) with ultrasound guided serratus anterior plane block 0.5 ml/kg 0.25% bupivacaine.

Erector Spinae Plane Block (ESPB) group

Patients will receive general anesthesia (GA) with ultrasound guided erector spinae plane block 0.5 ml/kg 0.25% bupivacaine.

Group Type: EXPERIMENTAL

Erector Spinae Plane Block (ESPB) group

Intervention Type: DRUG

Patients will receive general anesthesia (GA) with ultrasound guided erector spinae plane block 0.5 ml/kg 0.25% bupivacaine

Interventions

Control group

Patients will receive general anesthesia alone

Intervention Type: DRUG

Serratus Anterior Plane Block (SAPB) group

Patients will receive general anesthesia (GA) with ultrasound guided serratus anterior plane block 0.5 ml/kg 0.25% bupivacaine.

Intervention Type: DRUG

Erector Spinae Plane Block (ESPB) group

Patients will receive general anesthesia (GA) with ultrasound guided erector spinae plane block 0.5 ml/kg 0.25% bupivacaine

Intervention Type: DRUG

Other Intervention Names

General anesthesia; General anesthesia (GA) with bupivacaine; General anesthesia (GA) with bupivacaine

Eligibility Criteria

Inclusion Criteria

• Patient aged between 2 and 7 years.
• Patient posted for the right or left thoracotomy under general anesthesia.

Exclusion Criteria

• Parents who refuse regional anesthesia.
• Children who had any coagulation abnormality.
• Deformity of the thoracolumbar spine.
• Infection at the site of injection.
• History of allergy to the local anesthetics.

• Minimum Eligible Age: 2 Years
• Maximum Eligible Age: 7 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Tanta University

OTHER

Sponsor Role: lead

Responsible Party

Sarah Elsayed Mohamed Mohamed Hassan

Resident of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Tanta University

Tanta, El-Gharbia, Egypt

Countries

Egypt

Other Identifiers

36264MS209/6/23

Identifier Type: -

Identifier Source: org_study_id