Efficacy of transversus abdominis plane block for postoperative analgesia in pediatric patients undergoing operation on inguinal region

Abstract

Objective To evaluate the efficacy of transversus abdominis plane (TAP) block for postoperative analgesia in the pediatric patients undergoing operation on the inguinal region. Methods Sixty-four pediatric patients of both sexes, aged 1–3 yr, weighing 8.5–23.6 kg, of American Society of Anesthesiologists physical statusⅠ, undergoing elective unilateral high ligation of the hernia sac or high ligation of the processus vaginalis, were equally randomized into either intravenous analgesia group (group VA) or TAP block group (group TAP). In group TAP, after induction of anesthesia, the pediatric patients received ultrasound-guided TAP block with 0.2% ropivacaine 1 ml/kg injected locally.After the laryngeal mask airway was inserted, the pediatric patients were mechanically ventilated, and then inhaled 2%–3% sevoflurane for maintenance of anesthesia.In group VA, postoperative analgesia was performed with fentanyl 0.35 μg·kg–1·h–1 until 24 h after operation.The level of pain was rated using the FLACC pain scale.When FLACC score>5, fentanyl 0.25 μg/kg was injected intravenously as rescue analgesic.The occurrence of TAP block-related adverse events, time for removal of laryngeal mask airway, and occurrence of fentanyl-related nausea and vomiting, respiratory depression, and emergence agitation were recorded. Results No TAP block-related adverse events were observed in group TAP, and no respiratory depression was found in the two groups.Compared with group VA, the time for removal of laryngeal mask airway was significantly shortened, and the requirement for rescue analgesics and incidence of vomiting and emergence agitation were decreased in group TAP (P<0.05). Conclusion TAP block with 0.2% ropivacaine 1 ml/kg provides good efficacy for postoperative analgesia with good safety in the pediatric patients undergoing operation on the inguinal region. Key words: Nerve block; Abdominal muscles; Groin; Child; Analgesia