Appendectomy Pain Control by Transversus Abdominis Plane (TAP) Block in Children

Seyedhejazi, Mahin; Motarabbesoun, Samira; Eslampoor, Yashar; Taghizadieh, Nasrin; Hazhir, Nazanin

doi:10.5812/aapm.83975

Cited by 12 publications

(10 citation statements)

References 29 publications

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“…Except for Jalil et al, 75 comparing different doses of ropivacaine, all studies reported adequate baseline analgesia. All but one 77 showed a statistically and clinically significant pain reduction by use of the TAP block. Ghimire, as well as Patel and colleagues, demonstrated a reduction of pain lasting 12 h postoperatively 72,73 .…”

Section: Regional Analgesia Techniquesmentioning

confidence: 88%

“…Transverse abdominis plane block Twelve studies (three for laparoscopic appendicectomy in adults, [67][68][69] one for open appendicectomy in adults, 70 one for laparoscopic in children, 71 and seven for open appendicectomy in children) [72][73][74][75][76][77][78] assessed the analgesic effect of transverse abdominis plane (TAP) block. Eleven out of the twelve studies included adequate baseline analgesia.…”

Section: Regional Analgesia Techniquesmentioning

confidence: 99%

“…Out of the seven studies retrieved, three compared TAP block to no block, 73,74,77 two compared TAP block to placebo ('sham' TAP block), 72,76 one compared TAP block to local wound infiltration, 78 and one examined different dosing of ropivacaine used for TAP block. 75 All TAP blocks were performed unilaterally, utilising bupivacaine or ropivacaine as local anaesthetics.…”

Section: Open Appendicectomy: Paediatric Populationmentioning

confidence: 99%

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Perioperative pain management for appendicectomy

Freys,

Bigalke,

Mertes

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND Despite being a commonly performed surgical procedure, pain management for appendicectomy is often neglected because of insufficient evidence on the most effective treatment options. OBJECTIVE To provide evidence-based recommendations by assessing the available literature for optimal pain management after appendicectomy. DESIGN AND DATA SOURCES This systematic review-based guideline was conducted according to the PROSPECT methodology. Relevant randomised controlled trials, systematic reviews and meta-analyses in the English language from January 1999 to October 2022 were retrieved from MEDLINE, Embase and Cochrane Databases using PRISMA search protocols. ELIGIBILITY CRITERIA We included studies on adults and children. If articles reported combined data from different surgeries, they had to include specific information about appendicectomies. Studies needed to measure pain intensity using a visual analogue scale (VAS) or a numerical rating scale (NRS). Studies that did not report the precise appendicectomy technique were excluded. RESULTS Out of 1388 studies, 94 met the inclusion criteria. Based on evidence and consensus, the PROSPECT members agreed that basic analgesics [paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs)] should be administered perioperatively for open and laparoscopic appendicectomies. A laparoscopic approach is preferred because of lower pain scores. Additional recommendations for laparoscopic appendicectomies include a three-port laparoscopic approach and the instillation of intraperitoneal local anaesthetic. For open appendicectomy, a preoperative unilateral transverse abdominis plane (TAP) block is recommended. If not possible, preincisional infiltration with local anaesthetics is an alternative. Opioids should only be used as rescue analgesia. Limited evidence exists for TAP block in laparoscopic appendicectomy, analgesic adjuvants for TAP block, continuous wound infiltration after open appendicectomy and preoperative ketamine and dexamethasone. Recommendations apply to children and adults. CONCLUSION This review identified an optimal analgesic regimen for open and laparoscopic appendicectomy. Further randomised controlled trials should evaluate the use of regional analgesia and wound infiltrations with adequate baseline analgesia, especially during the recommended conventional three-port approach. REGISTRATION The protocol for this study was registered with the PROSPERO database (Registration No. CRD42023387994).

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Section: Regional Analgesia Techniquesmentioning

confidence: 88%

Section: Regional Analgesia Techniquesmentioning

confidence: 99%

Section: Open Appendicectomy: Paediatric Populationmentioning

confidence: 99%

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Perioperative pain management for appendicectomy

Freys,

Bigalke,

Mertes

et al. 2024

European Journal of Anaesthesiology

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“…The sample size was calculated using the effect size technique (ES), with ES=0.19, α=0.05 and 95% confidence level. 10 Sixty patients were divided into two groups of 30 each using the consecutive sampling technique, with group-A receiving Bupivacaine caudal block and group B receiving Bupivacaine wound infiltration after open herniotomy.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Bupivacaine Wound Infiltration with Bupivacaine Caudal Block on Postoperative Pain in Pediatric Open Inguinal Herniotomy

Saleem

Riaz

et al. 2022

PAFMJ

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Objective: To compare the effectiveness of Bupivacaine local wound infiltration with Bupivacaine caudal block on postoperative pain in children undergoing open inguinal hernia repair. Study Design: Quasi-experimental study. Place and Duration: Department of Paediatric Surgery, Pak Emirates Military Hospital Rawalpindi, from Jan to Sep 2019. Methodology: 60 patients (30 each in two groups) fulfilling the inclusion criteria who underwent open inguinal herniotomy were included in this study. Patients in group-A received caudal block with 0.25% Bupivacaine 1 ml/kg body weight, while Group-B received local wound infiltration of 0.5% Bupivacaine 2 mg/kg body weight after the completion of surgery. The post-operative pain score was calculated using Hannallah's objective pain scale at 30 minutes, one, two, four, six and eight hours following the procedure. A total pain score of 3 requiring the rescue analgesia in the form of oral Paracetamol (10 mg/kg body weight) was considered the endpoint. Results: Mean post-operative pain score was 8.20 ± 1.54 in group-A compared to 7.20 ± 1.88 in Group-B with the p-value of 0.02, which showed a statistically significant difference between the two groups. Conclusion: We concluded that local infiltration with Bupivacaine after open herniotomy in children is safe, highly effective and easy to perform the procedure, which results in excellent post-operative analgesia compared to caudal Bupivacaine block.

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“…The concentration and the dose of local anesthetics (LA) have particular importance for the success of pain control. Recent data from randomized controlled trials (RCTs) showed improved clinical efficacy of TAPB when using ultrasound (US) compared with other common pain control techniques [ 2 , 6 – 9 ]. The TAPB is an interfascial plane block; therefore, the success of the block depends on the volume of local anesthetic injected.…”

Section: Introductionmentioning

confidence: 99%

Transversus abdominis plane block with different bupivacaine concentrations in children undergoing unilateral inguinal hernia repair: a single-blind randomized clinical trial

et al. 2022

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Background Current knowledge on the ideal local anesthetic concentration for the ultrasound-guided transversus abdominis plane block (TAPB) in pediatrics is scarce. The purpose of this study is to compare the efficacy of US-guided TAPB at two different concentrations of bupivacaine in pediatrics undergoing unilateral inguinal hernia repair. Methods After random allocation, 74 children aged 1–8 were randomized to receive US-guided TAPB by using 1 mg.kg− 1 bupivacaine as either 0,25% (0,4 ml.kg− 1) (Group 1) or 0,125% (0,8 ml.kg− 1) (Group 2) concentration. All blocks were performed under general anesthesia, immediately after the induction, unilaterally with a lateral approach. All subjects received intravenous 15 mg/kg paracetamol 0.15 mg/kg dexamethasone and 0.1 mg/kg ondansetron intraoperatively. The primary outcome was the efficacy which is assessed by postoperative FLACC behavioral pain assessment score at 15′, 30′, 45′, 1 h, 2 h, 6 h, and 24 h. The secondary outcomes were to assess the total dose of rescue analgesic consumption, length of hospital stay, the incidence of side effects, complications and satisfaction levels of the patients’ parents and the surgeons. Results Sixty-four children were recruited for the study. Postoperative pain scores were equal between the two groups. There was no need for a rescue analgesic in any group after the postoperative 6thhour. No local or systemic complication or side effect related to anesthesia or surgery was reported. Conclusion TAPB using 1 mg.kg− 1 bupivacaine administered as either high volume/low concentration or low volume/high concentration was providing both adequate analgesia and no side effects. Trial registration This trial was retrospectively registered at Clinicaltrals.gov, NCT04202367.

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Appendectomy Pain Control by Transversus Abdominis Plane (TAP) Block in Children

Cited by 12 publications

References 29 publications

Perioperative pain management for appendicectomy

Perioperative pain management for appendicectomy

Comparison of Bupivacaine Wound Infiltration with Bupivacaine Caudal Block on Postoperative Pain in Pediatric Open Inguinal Herniotomy

Transversus abdominis plane block with different bupivacaine concentrations in children undergoing unilateral inguinal hernia repair: a single-blind randomized clinical trial

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