Does the Transversus Abdominis Plane Block Reduce Morbidity Following Iliac Crest Bone Harvest in Pediatric Patients...

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Oral and Maxillofacial Surgery

Background:

• Alveolar cleft repair often involves iliac crest bone grafting in pediatric patients.
• Donor site morbidity, including pain and opioid requirements, is a concern.
• Transversus Abdominis Plane (TAP) block is a regional anesthesia technique that may reduce postoperative pain.

Purpose of the Study:

• To evaluate the effectiveness of a Transversus Abdominis Plane (TAP) block in minimizing donor site morbidity.
• To assess the impact of TAP block on postoperative pain, opioid consumption, and length of stay in pediatric patients undergoing iliac crest bone grafting for alveolar cleft repair.

Main Methods:

• Retrospective cohort study including 66 pediatric patients.
• Patients were divided into two groups: intraoperative TAP block and intraoperative local anesthesia infiltration (control).
• Outcomes measured included postoperative pain scores, in-hospital narcotic requirements, and length of hospital stay.

Main Results:

• No significant difference in postoperative pain scores between the TAP block group and the control group (p=0.23).
• Mean length of stay was 1 day for both groups.
• A significantly higher proportion of patients in the TAP block group required in-hospital opioids compared to the control group (p=0.03).

Conclusions:

• The findings suggest that a TAP block may not be beneficial for reducing pain at the donor site in this patient population.
• There may be no role for TAP block in improving opioid stewardship for pediatric iliac crest bone grafting.
• Further research may be needed to explore alternative pain management strategies.