Clinical Trial: The Effect of Paravertebral Block With Dexamethasone on Intraoperative and Postoperative Analgesia in Children Undergoing Surgery for Coarctation of Aorta

Study Status: Active, not recruiting
Recruit Status: Active, not recruiting
Study Type: Interventional

Official Title: Paravertebral Block in Coarctation of the Aorta

Brief Summary: Anesthetic management for surgery of aortic coarctation needs special care due to severe pain during lateral thoracotomy incision, the intraoperative hemodynamic instability related to skin incision at lateral thoracotomy, clamping and declamping of the aorta, needs of large doses of analgesia perioperative, needs of vasodilators. Also, postoperative care of the patients after repair is very important issue. The investigators will compare the effect of para-vertebral block with bupivacaine alone or with dexamethasone on Intra and postoperative analgesia.

Detailed Summary: The patients will be divided randomly by sealed envelope into 2 equal groups. Group I (n=30) will receive paravertebral block with 0.5mg/kg bupivacaine 0.25% diluted with isotonic saline (total volume 15ml) and group II (n=30) will receive paravertebral block with 0.5mg/kg 0.25% bupivacaine and 0.1mg/kg dexamethasone.intraoperative fentanyl needs, Intra and postoperative hemodynamics and OPS pain scores will be recorded. Possible risks as hypertension will be treated by nitroglycerin infusion 0.5ug/kg/min or tachycardia (HR more than 20% than baseline) will be managed by additional doses of fentanyl 1-2ug/kg, bradycardia (20% decrease from the baseline) will be managed by atropine 0.02mg/kg. Also, the complications of paravertebral block as peridural and intravascular injection can be avoided by careful aspiration before injection and injection while visualization of the needle by U/S.
Sponsor: Cairo University

Current Primary Outcome:

  • Intraoperative fentanyl needs [ Time Frame: 3hours ]
    total fentanyl consumption intraoperatively
  • postoperative analgesic requirements [ Time Frame: 24hours ]
    total narcotic consumption


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • the first time the analgesic required [ Time Frame: 24 hours ]
    the time of narcotics need
  • extubation time [ Time Frame: 24 hours ]
    postoperative extubation


Original Secondary Outcome: Same as current

Information By: Cairo University

Dates:
Date Received: February 24, 2017
Date Started: October 30, 2016
Date Completion: April 15, 2017
Last Updated: March 8, 2017
Last Verified: March 2017