Axillary Brachial Plexus Block Using 0.25% Bupivacaine Versus Using 0.19%Bupivacaine in Pediatrics
Acute Postoperative Pain, Motor Activity
About this trial
This is an interventional prevention trial for Acute Postoperative Pain focused on measuring postoperative pain, axillary brachial plexus block, below elbow orthopedic surgeries, Bupivacaine, motor sparing block
Eligibility Criteria
Inclusion Criteria:
- American society of Anesthesiologists (ASA )class I-II
- Duration of surgery less than 1 hour.
Exclusion Criteria:
- Parent refusal.
- Prolonged procedure exceeding 1 hour.
- Patients with apparent infection at site of needle insertion.
- Patients with any coagulation disorder(Platelets ≤ 50,000 and/or international normalized ratio INR> 1.5)
- Patients with known neuropathy or brachial plexus injury.
- Patients with any cardiac, hepatic, renal failure.
- Patient with known sensitivity to local anesthetic drugs.
Sites / Locations
- Kasr Alainy Hospitals
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
0.25%Bupivacaine group
0.19%Bupivacaine group
Axillary brachial plexus block will be done with patient in supine position under general anesthesia . A total volume of (0.5ml/kg) 0.25% bupivacaine + 1 µg/kg dexmedetomidine.this volume will be divided equally among the median,ulnar,radial and the musculocutaneous nerve. The surgical procedure will be start after 15-20 min. At the end of surgery, residual neuromuscular block will be antagonized with IV neostigmine 0.05 mg/kg and atropine 0.02mg/kg. All patients will receive 15mg/kg paracetamol IV. At recovery room motor power will be assisted using Modified Bromage scale , then each 30 min till full recover of motor power. post operative pain assessment will be done using (FLACC score) for Pain assessment.For patients with pain score more than 4\10 ,Pethidine I.V will be given as rescue analgesic (1 mg/kg) when needed and total rescue analgesia will be recorded.
Axillary brachial plexus block will be performed with the patient in supine position under general anesthesia . A total volume of (0.5ml/kg) 0.19% bupivacaine + 1 µg/kg dexmedetomidine will be divided equally among the median,ulnar,radial and the musculocutaneous nerve. The surgical procedure will be start after 15-20 min.At the end of surgery, residual neuromuscular block will be antagonized with IV neostigmine 0.05 mg/kg and atropine 0.02mg/kg. All patients will receive 15mg/kg paracetamol IV. At recovery room motor power will be assessed using Modified Bromage scale , then each 30 min till full recover of motor power. post operative pain assessment will be done using (FLACC score) for Pain assessment,For patients with pain score more than 4\10 ,Pethidine I.V will be given as rescue analgesic (1 mg/kg) when needed and total rescue analgesia will be recorded..