TY - JOUR
T1 - Percutaneous ultrasound-guided vs. intraoperative rectus sheath block for pediatric umbilical hernia repair
T2 - A randomized clinical trial
AU - Litz, Cristen N.
AU - Farach, Sandra M.
AU - Fernandez, Allison M.
AU - Elliott, Richard
AU - Dolan, Jenny
AU - Patel, Nikhil
AU - Zamora, Lillian
AU - Colombani, Paul M.
AU - Walford, Nebbie
AU - Amankwah, Ernest K.
AU - Snyder, Christopher W.
AU - Danielson, Paul D.
AU - Chandler, Nicole M.
PY - 2017/2/24
Y1 - 2017/2/24
N2 - Background: Regional anesthesia is commonly used in children. Our hypothesis was that percutaneous ultrasound-guided (PERC) rectus sheath blocks would result in lower postoperative pain scores compared to intraoperative (IO) rectus sheath blocks following umbilical hernia repair. Methods: A single-institution randomized blinded trial was conducted in pediatric patients undergoing elective umbilical hernia repair. The primary outcome was mean postoperative Wong-Baker pain score. Secondary outcomes included narcotic requirements and length of postoperative stay. Results: Fifty-eight patients were included: 28 PERC and 30 IO. Operating room time was significantly longer in the PERC group (41 vs. 35. min, p. <. 0.01). Mean postoperative pain scores (PERC-2.6 vs. IO-3.3, p = 0.11), morphine equivalents intraoperatively (PERC-0 vs. IO-0.04. mg/kg, p = 0.29) and postoperatively (PERC-0.04 vs. IO-0.09. mg/kg, p = 0.17), time to first postoperative narcotic dose (PERC-30 vs. IO-22. min, p = 0.33, log-rank test), and postoperative length of stay (PERC-76 vs. IO-80. min, p = 0.44) were similar. Conclusion: Following umbilical hernia repair in children, percutaneous ultrasound-guided and intraoperative rectus sheath blocks resulted in similar mean postoperative pain scores. There were no differences in secondary outcomes such as time to first narcotic, narcotic requirements, and length of stay. The additional resources required to complete a percutaneous ultrasound-guided rectus sheath block may not be warranted. Type of study: Randomized controlled trial. Level of evidence: Level I.
AB - Background: Regional anesthesia is commonly used in children. Our hypothesis was that percutaneous ultrasound-guided (PERC) rectus sheath blocks would result in lower postoperative pain scores compared to intraoperative (IO) rectus sheath blocks following umbilical hernia repair. Methods: A single-institution randomized blinded trial was conducted in pediatric patients undergoing elective umbilical hernia repair. The primary outcome was mean postoperative Wong-Baker pain score. Secondary outcomes included narcotic requirements and length of postoperative stay. Results: Fifty-eight patients were included: 28 PERC and 30 IO. Operating room time was significantly longer in the PERC group (41 vs. 35. min, p. <. 0.01). Mean postoperative pain scores (PERC-2.6 vs. IO-3.3, p = 0.11), morphine equivalents intraoperatively (PERC-0 vs. IO-0.04. mg/kg, p = 0.29) and postoperatively (PERC-0.04 vs. IO-0.09. mg/kg, p = 0.17), time to first postoperative narcotic dose (PERC-30 vs. IO-22. min, p = 0.33, log-rank test), and postoperative length of stay (PERC-76 vs. IO-80. min, p = 0.44) were similar. Conclusion: Following umbilical hernia repair in children, percutaneous ultrasound-guided and intraoperative rectus sheath blocks resulted in similar mean postoperative pain scores. There were no differences in secondary outcomes such as time to first narcotic, narcotic requirements, and length of stay. The additional resources required to complete a percutaneous ultrasound-guided rectus sheath block may not be warranted. Type of study: Randomized controlled trial. Level of evidence: Level I.
KW - Pediatric
KW - Rectus sheath block
KW - Regional anesthesia
KW - Umbilical hernia
UR - http://www.scopus.com/inward/record.url?scp=85016411891&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016411891&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2017.03.007
DO - 10.1016/j.jpedsurg.2017.03.007
M3 - Article
C2 - 28377023
AN - SCOPUS:85016411891
SN - 0022-3468
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
ER -