Transversus Abdominis Plane Block
Conditions
Keywords
Transversus abdominis plane block, Bupivacaine, Concentration, Postoperative analgesia, Inguinal hernia repair surgery
Brief summary
This study is designed to compare the analgesic efficacy of different bupivacaine concentrations in pediatric patients undergoing ultrasound-guided transversus abdominis plane (TAP) block for unilateral inguinal hernia repair. In recruited 74 patients; Group 1 (n:37) received 1 mg/kg bupivakain 0.25% and Group 2 (n: 37) received 1 mg/kg bupivakain 0.125% for ultrasound-guided TAP block following standard general anaesthesia induction. FLACC (Face, Legs, Activity, Cry, Consolability) behavioral pain assessment scale was used for evaluating patients' postoperative pain levels at 15-, 30-, 45-minute and 1-, 2-, 6-, 24-hour. Tramadol 1 mg/kg was administered intravenously as rescue analgesic when FLACC score was ≥4. Total analgesic requirement, length of hospital stay and side effects were recorded.
Detailed description
Transversus abdominis plane (TAP) block is a safe and effective analgesia technique for paediatric patients. This study is designed to compare the analgesic efficacy of different bupivacaine concentrations in paediatric patients undergoing ultrasound-guided TAP blocks for unilateral inguinal hernia repair surgery. Seventy-four patients aging between 1 and 8 years, undergoing unilateral inguinal hernia surgery, were enrolled for this study after obtaining Institutional Ethics Committee approval and written informed consents from parents or legal guardians (2016/1281). Group 1 (n:37) received 1 mg/kg bupivakain 0.25% and Group 2 (n: 37) received 1 mg/kg bupivakain 0.125% for ultrasound-guided TAP block following standard general anaesthesia induction. All patients received remifentanil 0,1 μg/kg/h infusion and paracetamol 15 mg/kg intraoperatively, and paracetamol 4x15 mg/kg per day postoperatively. FLACC (Face, Legs, Activity, Cry, Consolability) behavioral pain assessment scale was used for evaluating patients' postoperative pain levels at 15-, 30-, 45-minute and 1-, 2-, 6-, 24-hour. Tramadol 1 mg/kg was administered intravenously as rescue analgesic when FLACC score was ≥4. Total analgesic requirement, length of hospital stay and side effects were recorded.
Interventions
Ultrasound-guided transversus abdominis plane block for unilateral inguinal hernia repair surgery.
Ultrasound-guided transversus abdominis plane block for unilateral inguinal hernia repair surgery.
Sponsors
Study design
Masking description
Seventy-four patients aging between 1 and 8 years, undergoing unilateral inguinal hernia surgery, were enrolled in the study and were randomized using closed envelope method.
Intervention model description
Ultrasound-guided TAP block was applied following standard general anaesthesia induction. All patients received remifentanil 0,1 μg/kg/h infusion and paracetamol 15 mg/kg intraoperatively, and paracetamol 4x15 mg/kg per day postoperatively.
Eligibility
Inclusion criteria
* American Society of Anesthesiologists (ASA) status I/II * Children between 1 to 8 years of age * Patients undergoing unilateral inguinal hernia repair surgery
Exclusion criteria
* Denial of parents * Patients who are allergic to local anesthetics
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FLACC pediatric pain scores | up to 24 hours | It corporates five categories of behavior, each scored on 0-2 point scale so that total score ranges from 0-10. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total analgesic requirement | up to 24 hours | Tramadol |
| First analgesic requirement time | up to 24 hours | Duration of postoperative analgesia |
| Incidence of side effects | up to 24 hours | Nausea, vomiting, respiratory depression |
| The length of hospital stay | up to 24 hours | Hospitalisation hours |
| Incidence of complications | up to first week. | Hemotoma, infection |