Year : 2016  |  Volume : 9  |  Issue : 3  |  Page : 403-408

Ultrasound-guided rectus sheath block for pediatric patients undergoing elective abdominal midline operations: a randomized controlled trial

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Mostafa M Hussein Khalil
5 Abdel-Azim Salama Street, Nasr City, Cairo, 11727, Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-7934.189570

Clinical trial registration PACTR201505001103180.

Rights and Permissions

Background Under high-resolution ultrasonic guidance, bilateral rectus sheath block (RSB) can be performed with higher success rate and fewer complications. RSB results in blocking the anterior branches of the lower thoracic spinal nerves supplying the central portion of the anterior abdominal wall. Objective The aim of the study was to assess the effectiveness of bilateral ultrasound-guided RSB in children undergoing elective midline abdominal operations. Patients and methods Fifty-six patients of both sexes between 2 and 10 years of age, of American Society of Anesthesiologists physical status I–II, undergoing elective midline abdominal procedures were involved in this randomized controlled trial. Patients were randomly allocated to one of two groups: 27 patients in group R (RSB group) and 29 patients in group C (control group). Both groups received general anesthesia. Group R received bilateral RSB with 0.3/ml/kg bupivacaine 0.25% under ultrasound guidance, and group C received regular analgesics. The primary outcome measure was degree of pain assessed using the Objective Pain Scale. The secondary outcome measures were hemodynamic parameters, intraoperative fentanyl requirement, and postoperative need for analgesia. Results Demographic and hemodynamic parameters were similar in both groups. Total intraoperative fentanyl requirement was significantly lower in group R compared with group C. Group R had a significantly lower pain score up to 24/h postoperatively compared with group C. The mean time to first postoperative rescue analgesia was significantly longer in group R (120.8±4.7/min) than in group C (48±3.6/min). The number of rescue doses of analgesia was significantly lower in group R [1 (0–1)] than in group C [3 (2–3)]. Conclusion Bilateral RSB under ultrasound guidance provides effective intraoperative and postoperative analgesia with more stable hemodynamics in pediatric patients undergoing elective midline abdominal procedures.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded168    
    Comments [Add]    
    Cited by others 2    

Recommend this journal