Caudal Versus Intravenous Magnesium Sulfate on Emergence Agitation After Sevoflurane In Children.

• Status: Unknown status
• Trial end date: 2019-08-01
• Target enrollment: 0
• Participant gender: All

Summary

Sevoflurane is the agent of choice for induction and maintenance of day care anesthesia in children and has a wide acceptance among pediatric anesthesiologists.

Emergence agitation (EA) is a frequent postoperative complication in pediatric patients receiving inhalational anesthetics with a rapid recovery, e.g. sevoflurane Magnesium sulfate is a non anesthetic N-methyl-D-aspartate receptor antagonist, Regional anesthetic techniques have major two benefits which are lowering anesthetic requirements intraoperatively and providing adequate postoperative pain relief.

Magnesium sulfate is an adjuvant that alters the perception and duration of pain by serving as an antagonist of N-methyl-D-aspartate glutamate receptors. Caudal injection of bupivacaine with magnesium sulfate in pediatric patients after inguinoscrotal operations provided adequate postoperative analgesia without producing many side effects. Caudal block with local anesthetic with or without adjuvants may prevent emergence agitation with effective postoperative pain management.

• So the aim of this study is to compare the efficacy of caudal versus intravenous magnesium sulfate infusions in controlling emergence agitations after inhalational sevoflurane anesthesia in children who will undergo lower abdominal surgeries.

Participants and methods

All participants will receive caudal block with bupivacaine 0.25% 1mg/kg dialed in 10 cm saline.

The participants will be divided to 3 groups

1. Bupivacaine group (B group) (group 1) N = 31 :-

2. Magnesium sulfate caudal group (MC group) (group 2) N = 31 :-

3. Magnesium sulfate I.V group (MV group) (group 3) N = 31 :-

Postoperative assessment in the ( PACU):-

• The oxygen saturation (SO2), heart rate (HR), and mean arterial pressure (MAP) are monitored by the observer blinded to group allocation on admission and 10 mins till discharge (0, 10, 20, 30, 40, 50, 60mints, time of discharge) from the PACU.

• Emergence agitations (Pediatric anesthesia emergency delirium scale (PAED) The presence of Emergence agitation and its severity will be measured using (PAED).

The presence of Pain and its severity will be measured using FLACC scale.

• Time of first postoperative administration of fentanyl in mints

• Modified Aldrete score :- The discharge from the PACU will be measured using Modified Aldrete score.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Mansoura University
• Treatments: Anesthetics; Anesthetics, Local; Bupivacaine; Magnesium Sulfate; N-Methylaspartate; Sevoflurane

Criteria

Inclusion Criteria:

-All participants undergoing lower abdominal surgeries

Exclusion Criteria:

All participants with:-

• history of developmental delay,

• mental retardation,

• psychological disorders or

• Epilepsy which can make observational pain intensity assessment difficult,

• a known or suspect coagulopathy,

• a known allergy to any of the study drugs and

• any signs of infection at the site of the proposed caudal block.