Laparoscopic Guided Transversus Abdominis Plane Block for Postoperative Analgesia After Pediatric Laparoscopic Surgery. (TAB)

Assiut University

Status and phase: Unknown; Phase 3; Phase 2

Conditions: Analgesia

Treatments: Procedure: TAB Block; Drug: Bupivacaine; Procedure: Psoas Block

Study type: Interventional

Funder types: Other

Identifiers

NCT03388671

17300080

Details and patient eligibility

About

The aim of this study will be to investigate the safety and analgesic efficacy of Transversus Abdominis Plane (TAB) Block versus psoas block blockade. Both blocks will be administered surgically and guided by the laparoscopy screen in children undergoing laparoscopic surgery.

Full description

Transversus abdominis plane (TAP) block is a promising effective method for postoperative pain control after major abdominal surgery. TAP block provides analgesia by inhibiting nerve conduction from the anterior abdominal wall arising from the intercostal nerves, subcostal nerves, and first lumbar nerve (T6-L1). Using a landmark technique, it is easily performed, but its popularity has decreased because of reduced efficacy due to inaccurate injection and the potential for intra-peritoneal organ damage. Ultrasound-guided TAP block provides better results and fewer complications, but it requires experienced operators. Surgically administered TAP (sTAP) block guided by the video camera of the laparoscope is a simple technique and may cause no complications. Also, under laparoscopic guidance, block of ilioinguinal, iliohypogastric, and genitofemoral nerves can be possible with anesthetic injection in the plane between psoas major and the fasciae covering its anterior aspects [laparoscopic-assisted psoas (LAP) blockade].

Enrollment: 44 estimated patients

Sex: All

Ages: 1 to 6 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children (1-6 years) of both sexes undergoing elective laparoscopic surgeries that last >30minutes (eg. undescended testis and inguinal hernia repair).
• Written consent, free and informed

Exclusion criteria

• Significant respiratory, cardiac or renal disease
• BMI >95th percentile for age.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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44 participants in 2 patient groups

TAB Block

Active Comparator group

Description:

Patients will recieve 0.3ml/kg bupivacaine 0.25% on each side for laparoscopically guided Transversus abdominis plane block.

Treatment:

Procedure: TAB Block

Drug: Bupivacaine

Psoas Block

Active Comparator group

Description:

Patients will recieve 0.3ml/kg bupivacaine 0.25% on each side for laparoscopically guided psoas block.

Treatment:

Procedure: Psoas Block

Drug: Bupivacaine