Inguinal Hernia Repair, Laparoscopic, Laparoscopic Intraperitoneal Instillation, Pediatrics, Transversus Abdominis Plane Block, Ultrasound
Conditions
Brief summary
The aim of this study is to compare laparoscopic -assisted, ultrasound-guided transversus abdominis plane block and laparoscopic intraperitoneal instillation of local anesthetic in pediatrics undergoing inguinal hernia repair.
Detailed description
Inguinal hernia is one of the most common pediatric surgeries. Effective and safe pain management causes fewer side effects and enables faster hospital discharge. It is also important in overcoming chronic pain in the late postoperative period. Transversus abdominis plane block (TAPB) has emerged as a safe, simple, and inexpensive modality incorporated into many enhanced recovery pathways to achieve narcotic-sparing analgesia after bariatric surgery. TAPB was first performed through the lumbar triangle of Petit in 2001. Since that time, both ultrasound-guided (US) and laparoscopic (LAP) TAPBs have been developed to aid in proper identification of the correct plane and minimize peritoneal penetration.
Interventions
This group will receive ultrasound-guided transversus abdominis plane block by using 1 ml/kg of bupivacaine 0.25% with a maximum volume of 20 mL as a control group.
PROCEDURELaparoscopic-assisted transversus abdominis plane block
Patients will receive laparoscopic-assisted transversus abdominis plane block by using 1 ml/kg of bupivacaine 0.25% with a maximum volume of 20 mL.
PROCEDURELaparoscopic-assisted intraperitoneal instillation
This group will receive laparoscopic-assisted intraperitoneal instillation by using 1 ml/kg of bupivacaine 0.25% with a maximum volume of 20 mL will be instilled into the peritoneal cavity immediately after gas insufflation.
DRUGBupivacaine
bupivacaine
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
2 Months to 7 Years
Healthy volunteers
No
Inclusion criteria
* Age: 2 months to 7 years old * Both sexes. * American Society of Anesthesiologists (ASA) I-II. * Schedule for elective unilateral inguinal hernia repair.
Exclusion criteria
* Patients with history of allergy. * Hepatic and renal failure. * Previous inguinal surgery. * Block contraindications (e.g., infection at the site of block, bleeding disorder, or abnormalities of the sacrum).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total postoperative pethidine consumption | 24 hours postoperatively | The patient will be given supplementary paracetamol I.V. injection in a dose of 15 mg/kg as routine analgesia. If the FLACC score is \> 3, pethidine 0.5 mg/kg. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-operative pain scores | 24 hours postoperatively | Face, Legs, Activity, Cry and Consolability (FLACC) scale will be used for postoperative pain assessment. This scale ranges from 0 to 10 where 0 represents no pain and 10 represents worst possible pain. FLACC scale will be measured at 30 minutes and then at 2, 4, 6, 12, 18 and 24 hours. |
| Time of first analgesia request. | 24 hours postoperatively | Time of first analgesic requirement, which represent the time elapsed from the end of the surgery till the first request of rescue analgesia. |
| Incidence of adverse events | 24 hours postoperatively | Complication related to the block or adverse events of the administered drugs. |
Countries
Egypt
Outcome results
None listed