Caudal Versus Rectus Sheath Study

This study is enrolling participants by invitation only.
Information provided by (Responsible Party):
Tarun Bhalla, MD, Nationwide Children's Hospital Identifier:
First received: July 11, 2011
Last updated: February 5, 2015
Last verified: February 2015
The literature has clearly demonstrated that the effective treatment of postoperative pain in infants and children is challenging. In an effort to improve postoperative analgesia while limiting opioid-related adverse effects, there continues to be an increased use of regional anesthetic techniques in infants and children. Although the pediatric caudal remains the most commonly used pediatric regional anesthetic technique, it has been demonstrated that effective analgesia can be provided with the use of peripheral nerve blockade even in the pediatric-aged patient. The purpose of this study is to prospectively compare post-operative pain relief in pediatric patients undergoing umbilical hernia repair who have received either a caudal block or bilateral rectus sheath blocks for analgesia

Condition Intervention Phase
Umbilical Hernia
Drug: Bupivacaine
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Prospective, Double-blinded, Randomized Comparison of Caudal Analgesia Versus Ultrasound Guided Rectus Sheath Blocks for Umbilical Herniorrhaphy in the Pediatric Population

Resource links provided by NLM:

Further study details as provided by Nationwide Children's Hospital:

Primary Outcome Measures:
  • Post-operative pain score [ Time Frame: 60 minutes ] [ Designated as safety issue: No ]

Estimated Enrollment: 75
Study Start Date: August 2011
Estimated Study Completion Date: December 2016
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Caudal epidural
The caudal epidural block will be delivered with 1.5ml/kg of 0.25% Bupivacaine up to a maximum of 30 mL.
Drug: Bupivacaine
0.25% or 0.5%
Active Comparator: Rectus sheath
The rectus sheath block will be performed with 0.1ml/kg of 0.25% Bupivacaine on each side at the T9-T10 distribution under ultrasound guidance.
Drug: Bupivacaine
0.25% or 0.5%
Active Comparator: Local
The surgeon will inject either 0.5% Bupivicaine 0.5ml/kg or 0.25% Bupivicaine 1ml/kg at the surgeon's discretion.
Drug: Bupivacaine
0.25% or 0.5%


Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • ASA physical status I or II
  • Weight less than or equal to 20 kg
  • Presenting for repair of umbilical hernia

Exclusion Criteria:

  • ASA physical status > II
  • Weight greater than 20 kg
  • Co-morbid diseases (cardiac, pulmonary, neurological disease)
  • Patients having concomitant procedures (circumcision, orchiopexy, etc.)
  Contacts and Locations
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Please refer to this study by its identifier: NCT01394523

United States, Ohio
Nationwide Children's Hospital
Columbus, Ohio, United States, 43205
Sponsors and Collaborators
Nationwide Children's Hospital
  More Information

No publications provided

Responsible Party: Tarun Bhalla, MD, Attending Anesthesiologist, Nationwide Children's Hospital Identifier: NCT01394523     History of Changes
Other Study ID Numbers: IRB11-00363 
Study First Received: July 11, 2011
Last Updated: February 5, 2015
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Hernia, Umbilical
Hernia, Abdominal
Hernia, Ventral
Infant, Newborn, Diseases
Pathological Conditions, Anatomical
Anesthetics, Local
Central Nervous System Agents
Central Nervous System Depressants
Peripheral Nervous System Agents
Pharmacologic Actions
Physiological Effects of Drugs
Sensory System Agents
Therapeutic Uses processed this record on February 11, 2016