Application of Continuous Sacral Block Guided by Ultrasound After Comprehensive Sacral Canal Scanning in Children Undergoing Laparoscopic Surgery: A Prospective, Randomized, Double-Blind Study

Ting-ting Yan,* Xin-lu Yang,* Shan Wang, Jia-qi Chen, Ji-cheng Hu, Ling Zhou, Wei Gao Department of Anesthesiology, First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wei Gao; Ling Zhou, Department of Anesthesiology, First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China, Tel +86-15605690073 ; +86-13866702756, Fax +86-551-62283912, Email gaowei20100813@126.com; 13866702756@163.comPurpose: The present study aimed to explore the effects of continuous sacral block on the postoperative pain of children and the satisfaction of the nurses in post-anesthesia care unit (PACU). Also, the influence of the modified protocol of continuous sacral block was investigated.Patients and Methods: A total of 60 children undergoing laparoscopic surgery were randomly divided into two groups: GI and GC groups. The general anesthesia was induced with midazolam, propofol, sufentanil and succinylcholine in both groups. In addition, the patients were subjected to continuous sacral block with levobupivacaine in group GC. The modified protocol of continuous sacral block was divided into three steps: comprehensive lumbar and sacral vertebral canal scanning by ultrasound, catheterization and administration. The EVENDOL pain scales and pediatric anesthesia emergence delirium scales of the children were evaluated at 5 min after extubation (T3), 90 min (T4), and 4 h (T5) after the operation. The nurses’ satisfaction scores at T3 -T4 and adverse events, such as nausea and vomiting, were also recorded, after the operation.Results: After ultrasonic scanning, one patient in group GC was excluded due to the sacral hiatus atresia, which might lead to failure of catheterization. Data of 59 patients were collected for statistical analysis. Compared to the GI group, the EVENDOL scores and the pediatric anesthesia emergence delirium scales were reduced at T3, T4, and T5 (P < 0.05) in group GC. Furthermore, there was a higher rank of PACU nurses’ satisfaction in the GC group compared to the GI group (P < 0.05).Conclusion: Based on the modified protocol, continuous sacral block provides reliable and safety analgesia for children undergoing laparoscopic surgery, thereby improving the satisfaction of PACU nurses.Keywords: ultrasound-guided, lumbar and sacral vertebral canal scanning, postoperative pain, satisfaction of PACU nurses