Comparison of the analgesic effect of ultrasound-guided posterior quadratus lumborum block and ultrasound-guided ilioinguinal/iliohypogastric nerve block for pediatric lower abdominal surgery: A Prospective, randomized double-blinded study

Comparison of the analgesic effect of ultrasound-guided posterior quadratus lumborum block and ultrasound-guided ilioinguinal/iliohypogastric nerve block for pediatric lower abdominal surgery

Clinical trial with parallel groups, double-blind, randomized, phase 3 on 60 children candidates for lower abdominal surgeries, computer software will be used for randomization.

This study is conducted in Ali Asghar Children's Hospital. Eligible children and candidates for inguinal hernia surgery and orchiopexy are randomly assigned to 2 groups.After induction of anesthesia in group 1 quadratus lumborum block and in group 2 ilioinguinal/iliohipogastric block both will be performed under ultrasound guidance. In this study, children do not know the type of treatment method.

Entry criteria included: Candidate patients for unilateral inguinal hernia surgery and unilateral orchiopexy in the age range of 4 to 12 years , and Having informed consent from parents, ; Exclusion criteria include a history of surgery in the block area, Coagulation disorder, ASA class three and above, drug use before surgery, sensitivity to local anesthetics, infection or redness at the injection site, liver, kidney and heart diseases and children with cerebral palsy.

In group 1,or Quadratus Lumbarum group: First, to confirm the correct location of the needle tip, 0.5cc of normal saline is injected And then 0.5cc/kg of ropivacaine 0.2% will be injected after negative aspiration. In group 2,or ilioinguinal/iliohypogastric group :First 0.5cc of normal saline will be injected to confirm the correct location And after confirming the location and performing negative aspiration, 0.2cc/kg ropivacaine 0.2% will be slowly injected around the nerve.

Pain score

In this study, simple and individual randomization method is used.The Sealed Envelope site is used to generate random sequences. The website address is https://www.sealedenvelope.com.Each of the generated random sequences contains a unique code for hiding.First, using a computer program, such as Microsoft Excel or SAS, a sequence of random numbers will be generated Then, based on the randomization sequence, the participants will be assigned to 2 quadratus lumborum block groups and ilioinguinal/iliohipogaster block groups, And by using sealed envelopes, this allocation will be hidden, And the participants will be assigned to the appropriate groups according to the order of allocation.

Blinding the patient: due to their condition and being unconscious, the patients are unaware of the treatment process and the patient's companion does not know which method was used for the disease. Blinding of the outcome assessor: Data collectors will not be aware of the type of block and management during surgery and postoperative evaluation and will record all hemodynamic items, questionnaire interventions, and postoperative evaluations.