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Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a

John Carney1, Olivia Finnerty, Jassim Rauf

  • 1Department of Anaesthesia, Clinical Sciences Institute, National University of Ireland, Galway, Ireland. john.laffey@nuigalway.ie

Anesthesia and Analgesia
|August 31, 2010
PubMed

Insights

The transversus abdominis plane (TAP) block significantly reduced pain and morphine use in children after appendectomy. This study confirms its effectiveness as part of multimodal analgesia, with no observed complications.

Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia
  • Pain Management

Background:

  • Transversus abdominis plane (TAP) block is effective for postoperative pain in adults.
  • Efficacy in pediatric patients undergoing abdominal surgery is not well-established.
  • Lack of randomized clinical trials in children necessitates further investigation.

Purpose of the Study:

  • To evaluate the analgesic efficacy of unilateral TAP block in children.
  • To assess pain management over the first 48 postoperative hours after appendectomy.
  • To compare TAP block with ropivacaine versus placebo in a pediatric appendectomy cohort.

Main Methods:

  • Randomized, controlled, double-blind clinical trial involving 40 children.
  • Unilateral TAP block with ropivacaine or placebo administered post-anesthesia induction.
  • Standard postoperative analgesia included IV morphine, diclofenac, and acetaminophen.

Main Results:

  • TAP block significantly reduced mean morphine requirements (10.3 vs 22.3 mg) in the first 48 hours (P < 0.01).
  • Reduced visual analog scale pain scores at rest and during movement were observed.
  • No significant differences in sedation, nausea, vomiting, or TAP block-related complications.

Conclusions:

  • Unilateral TAP block is a safe and effective component of multimodal analgesia for pediatric appendectomy.
  • Provides superior postoperative analgesia compared to placebo in the first 48 hours.
  • Supports the use of TAP block for pain management in children undergoing abdominal surgery.
Abstract

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