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Comparison of ultrasound-guided transversus abdominis plane (TAP) block versus local infiltration during paediatric

Priyanka P Karnik1, Nandini M Dave1, Harick B Shah1

  • 1Department of Anesthesiology, Seth Gordhandas Sunderdas Medical College, King Edward Memorial Hospital, Mumbai, Maharashtra, India.

Indian Journal of Anaesthesia
|May 31, 2019
PubMed

Insights

Ultrasonography-guided transversus abdominis plane (TAP) blocks provide superior pain relief compared to local infiltration in children undergoing laparoscopic surgery. This method significantly reduces both intraoperative and postoperative opioid requirements and pain scores.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Pediatric laparoscopic surgeries often involve significant postoperative pain.
  • Effective analgesia is crucial for patient recovery and minimizing complications.
  • Current analgesic techniques require evaluation for optimal efficacy.

Purpose of the Study:

  • To compare the analgesic efficacy of ultrasonography-guided transversus abdominis plane (TAP) blocks versus local port site infiltration in pediatric laparoscopic surgery.
  • To assess intraoperative hemodynamics, opioid requirements, and postoperative pain.
  • To evaluate the need for rescue analgesia in the immediate postoperative period.

Main Methods:

  • A randomized study involving 92 children (aged 2-12 years) undergoing laparoscopic surgery.
  • Group T received bilateral TAP blocks under ultrasonographic guidance with bupivacaine.
  • Group L received local port site infiltration with bupivacaine by the surgeon.

Main Results:

  • TAP block group showed significantly lower postoperative pain scores at multiple time points (10 min, 30 min, 1 h, 2 h) compared to local infiltration (P < 0.05).
  • The need for intraoperative opioids was significantly reduced in the TAP block group (P < 0.001).
  • Rescue analgesia requirements were significantly lower in the TAP block group (P < 0.001).

Conclusions:

  • Ultrasonography-guided TAP block is a superior analgesic technique for pediatric laparoscopic surgeries.
  • TAP blocks offer effective intraoperative and immediate postoperative pain management.
  • This technique enhances recovery by reducing opioid consumption and pain.
Abstract

Keywords:
Anaesthesiachildrenlaparoscopic surgeriespostoperative painultrasonography

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