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The efficacy of transversalis fascia plane block in pediatric inguinal herniotomy: a randomized controlled study
Elif O Ahiskalioglu1, Erkan C Celik1, Binali Firinci2
1Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.
Insights
The transversalis fascia plane (TFP) block significantly reduces post-operative pain and increases family satisfaction in pediatric herniotomy patients. This approach requires fewer additional analgesics compared to standard methods.
Area of Science:
- Pediatric Anesthesiology
- Regional Anesthesia
- Pain Management
Background:
- The analgesic efficacy of transversalis fascia plane (TFP) block in pediatric patients undergoing herniotomy is debated.
- Optimizing post-operative pain control is crucial for pediatric surgical recovery.
Purpose of the Study:
- To compare the post-operative analgesic efficacy of the TFP block versus standard analgesic methods in pediatric patients undergoing open herniotomy.
- To evaluate pain scores, family satisfaction, and analgesic requirements after TFP block.
Main Methods:
- A randomized controlled trial involving 60 pediatric patients (1-8 years) undergoing open herniotomy.
- Patients were divided into two groups: TFP block (n=30) receiving 0.25% bupivacaine or a control group (n=30) receiving routine analgesia.
- Outcomes measured included FLACC pain scores, family satisfaction, nausea, sedation, and additional analgesic needs.
Main Results:
- FLACC pain scores were significantly lower in the TFP block group at all measured post-operative time points (p < 0.05).
- Fewer patients in the TFP group required rescue analgesics (p = 0.015) or ibuprofen (p = 0.010).
- Parental satisfaction was significantly higher in the TFP group (p < 0.001), with no significant differences in nausea or sedation.
Conclusions:
- The transversalis fascia plane (TFP) block is an effective component of multimodal analgesia for pediatric herniotomy.
- TFP block leads to reduced early post-operative pain, decreased need for supplementary analgesics, and improved parental satisfaction.
- This regional anesthesia technique offers a beneficial approach to pediatric post-operative pain management.
Objective:
The post-operative analgesic efficacy of transversalis fascia plane (TFP) block is controversial in pediatric patients undergoing herniotomy. This study aims to compare the efficacy of TFP block and standard analgesic methods.
Methods:
Sixty patients aged 1-8 years who underwent the open procedure of herniotomy were randomly divided into two groups TFP block (n = 30) or control group (n = 30). The TFP group received 0.25% bupivacaine at 0.5 mL/kg. Routine analgesia protocol was applied to Group C. Pain scores (FLACC), family satisfaction, block complications, nausea, sedation score, and additional analgesic requirements were recorded.
Results:
FLACC pain scores at post-anesthesia care unit (PACU), 1st, 2nd, and 4th h were statistically significantly lower in Group TFP compared to group control (p < 0.05). Three patients in Group TFP and 12 in group control required rescue analgesics at PACU (p = 0.015). Ibuprofen was required in two patients in Group TFP and 11 in Group Control (p = 0.010). Parental satisfaction is higher in the TFP group than in Group Control (p < 0.001). There was no statistically significant difference between the groups in terms of post-operative nausea and sedation scores (p > 0.05).
Conclusion:
We conclude that TFP block in pediatric patients is an appropriate approach as a part of multimodal analgesia. It creates fewer pain scores in the early post-operative period, requires less additional analgesia, and increases family satisfaction.
