Efficacy of Ultrasound-guided Greater Auricular Nerve Block in Preventing Postoperative Emergence Agitation in Pediatric Patients Undergoing Microscopic Middle Ear Surgery

What this Trial Is About

Researchers are evaluating whether an ultrasound-guided greater auricular nerve block (GANB) can reduce emergence agitation (EA), a common delirium and psychomotor agitation occurring shortly after anesthesia, in children undergoing microscopic middle ear surgery. The study focuses on pediatric patients aged 5 to 14 years, as this group is at higher risk for EA, especially after ear surgeries involving significant pain and nerve stimulation. The trial is designed as a prospective, randomized, double-blinded clinical trial to assess the effect of GANB on EA occurrence and severity. Participants will be randomly assigned to one of two groups. One group will receive a unilateral ultrasound-guided GANB with 0.25% Bupivacaine shortly after anesthesia induction and before surgery begins. The control group will receive no nerve block; however, to maintain blinding, an ultrasound probe will be applied without needle insertion or injection. This procedure aims to compare the effectiveness of the nerve block in reducing postoperative pain and agitation. During the study, children's emergence from anesthesia will be closely monitored using the Pediatric Anesthesia Emergence Delirium (PAED) scale at regular intervals for up to two hours after extubation. Researchers will also measure time to emergence, pain intensity, need for additional pain or sedation medications, post-anesthesia care unit stay length, and incidence of nausea, vomiting, or oxygen desaturation. Participation involves assessments during surgery and recovery, with follow-up lasting up to three hours post-emergence.

Efficacy of Ultrasound-guided Greater Auricular Nerve Block in Preventing Postoperative Emergence Agitation in Pediatric Patients Undergoing Microscopic Middle Ear Surgery.