Contribution of Ultrasound-Guided Transversus Abdominis Plane Block to Intraoperative Anesthesia in children - Randomized Controlled Study

Abstract

Aim: The aim of this study is to investigate the contribution of transversus abdominis plane (TAP) block supported by intravenous ketamine sedation in children on intraoperative anesthesia and analgesia. Method: A total of 60 patients aged between 2 and 6 years, were included in the study. The patients were divided in three groups; the TAP block and ketamine group; the TAP block by inserting the laryngeal mask(LMA) and sevoflurane grup; and the LMA and sevoflurane group. Peroperative heart rates(HR), mean arterial pressures(MAP), amount of sevoflurane used, postoperative pain scores, number of children needing rescue analgesia, time required for the first analgesia were recorded. Results: Of the patients average age was 4 ± 1.1. There was no difference between the two block groups, in terms of HR and MAP; HR were higher and MAP were lower in the only sevoflurane group. In the group supported by a TAP block, the amount of sevoflurane used decreased(p<005). In the postoperative period, the HR, MAP and pain scores were higher in the only sevoflurane group(p <0,05). Rescue analgesia was applied to less number of patients in the groups with added block. There were longer analgesia durations in the block-supported groups(p<0.05). Conclusion: In this study, it was determined that TAP block added to general anesthesia or sedation in pediatric lower abdominal surgery reduced the need for intraoperative anesthesia, provided a more stable intraoperative hemodynamics and analgesia, and provided less pain scores, longer analgesia duration and less analgesia need in the postoperative period.