Effect of addition of different additives: Magnesium sulfate and dexamethasone versus plain bupivacaine in ultrasound-guided erector spinae plane block in pediatrics undergoing repair of inguinal hernia
Bibliographic record
Abstract
Background Erector spinae plane (ESP) block has been evaluated in many studies in pediatric surgeries by the use of postoperative rescue analgesia which is the objective parameter assessing the efficacy of the technique in controlling postoperative pain. Adjuvants were used with ESP block to densify its postoperative analgesia. Magnesium sulfate was used for suppressing somatic, endocrine and autonomic reflexes induced by noxious stimuli during surgery. Dexamethasone is a highly potent glucocorticoid that has been used in different regional anesthesia to prolong the anesthetic effect of the local anesthesia by inducing local vasoconstriction.Methodology Sixty pediatric patients underwent inguinal hernia repair under general anesthesia, and then they were assigned randomly into three groups that received ESP block either with local anesthetic alone or with magnesium sulfate or dexamethasone.Results Our study revealed no statistical significance among the three groups as regards demographic and vital data. Children’s Hospital Eastern Ontario Pain Scale score for postoperative assessment of magnesium sulfate and dexamethasone which were added to bupivacaine in ESP block had a better score than bupivacaine alone with high statistical significance. Also, magnesium sulfate and dexamethasone had a delayed first-dose postoperative rescue analgesia with significant statistical value (P value = 0.002) and total postoperative doses of postoperative rescue analgesia were lesser in magnesium sulfate and dexamethasone groups with marked statistical significance (P value < 0.001). As regards complications, there were minor ones in the form of mild bruising and mild pain at injection site with no statistical significance between the three groups (P value = 0.108).Conclusion In our study, magnesium sulfate and dexamethasone added to bupivacaine in ESP block prolonged the duration of postoperative pain control and decreased the consumption of postoperative analgesia than bupivacaine alone. No major complications were recorded in our study in the three groups which solidify the safety of the technique.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".