TAP block comfort for lower abdominal surgery in pediatric patients
Öz
Purpose: The aim of this study was to examine the effect of The transversus abdominis plane (TAP) block after lower abdominal surgery on pain severity and additional analgesic requirement in a pediatric patient group.
Materials and Methods: In this retrospective study, 46 ASA I children aged 2-18 years undergoing abdominal surgery were divided into two groups. Group T (n: 20) patients who were under the general anesthesia received ultrasound-guided TAP block with 0.5 mL/kg of 0.25% bupivacaine immediately after the operation. Group O (n: 26) patients were administered intravenous (I.V.) 2 µcg/kg opioid (fentanyl) analgesia after recovery from general anesthesia. The patients were taken to the post-anesthesia care unit (PACU) for recovery and initial pain observation. Patients pain was assessed by using the Visual Analogue Scale (VAS) score within the first 24 hours following surgery.
Results: The incidence of the additional analgesic requirement in the TAP block(%15) group was statistically significantly lower than in the I.V. opioid group(%65). There was a difference between the first analgesic requirement and the discharging time according to TAP block administration, but it was statistically insignificant. The VAS scores at 4 hr and 8 hr in the TAP block group were statistically significantly lower than in the IV opioid group(4.VAS:4.90±1,21 5.90±0.85; 8.VAS:4.05±0.76 3.10±0.85). The VAS scores at postoperative 2 hr were decreased in both groups. However, the decrease in the VAS score at 2 hr was greater in the TAP block group.
Conclusion: TAP block was superior to IV opioids in reducing additional analgesic requirements in pediatric patients undergoing abdominal surgery. It will contribute further to early discharging a patient as it allows early mobilization.
Anahtar Kelimeler
TAP block, pediatric patient, abdominal surgery, VAS, opioid
Kaynakça
- Gupta R, Singh S. Challenges in paediatric laparoscopic surgeries. Indian J Anaesth. 2009;53:560–6.
- Netter FH. Back and spinal cord. In: Netter FH, editor. Atlas of Human Anatomy. Summit, NJ, USA: The Ciba-Geigy Corporation. 1989;145–55.
- Suresh S Chan. VWS Ultrasound guided transverses abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance. Paediatr Anaesth. 2009;19:296-9.
- Rafi AN. Abdominal field block: a new approach via the lumbar triangle. Anaesthesia. 2001;56:1024-6.
- Hebbard P, Fujiwara Y, Shibata Y, Royse C. Ultrasound-guided transversus abdominis plane (TAP) block. Anaesth Intensive Care. 2007;35: 616-7.
- Hamer C, Murphy P, Diwan R. Does neonatal transverse abdominal plane block remove the need for postoperative opioid infusion? A case series of neonatal laparotomies. Pediatr Anesth. 2012;22:913-4.
- Jacobs A, Bergmans E, Arul GS, Thies KC. The transversus abdominis plane (TAP) block in neonates and infants – results of an audit. Paediatr Anaesth. 2011;21:1078-80.
- Carney J, Finnerty O, Rauf J, Curley G, McDonnell JG, Laffey JG. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial. Anesth Analg. 2010;111:998-1003.
- Wu Y, Liu F, Tang H, Wang Q, Chen L, Wu H et al. The analgesic efficacy of subcostal transversus abdominis plane block compared with thoracic epidural analgesia and intravenous opioid analgesia after radical gastrectomy. Anesth Analg. 2013;117:507–13.
- Kukanich B, Clark TP. The history and pharmacology of fentanyl: relevance to a novel, long-acting transdermal fentanyl solution newly approved for use in dogs. J Vet Pharmacol Ther. 2012;35:3-19.
