Laparoscopic vs Ultrasound-Guided Transversus Abdominis Plane Block vs Laparoscopic Intraperitoneal Instillation of Local Anesthetic in Pediatrics

Tanta University

Status: Completed

Conditions: Inguinal Hernia Repair; Pediatrics; Laparoscopic; Laparoscopic Intraperitoneal Instillation; Transversus Abdominis Plane Block; Ultrasound

Treatments: Procedure: Laparoscopic-assisted intraperitoneal instillation; Procedure: Laparoscopic-assisted transversus abdominis plane block; Drug: Bupivacaine; Procedure: Ultrasound-guided transversus abdominis plane block

Study type: Interventional

Funder types: Other

Identifiers

NCT06098105

36264PR352/9/23

Details and patient eligibility

About

The aim of this study is to compare laparoscopic -assisted, ultrasound-guided transversus abdominis plane block and laparoscopic intraperitoneal instillation of local anesthetic in pediatrics undergoing inguinal hernia repair.

Full description

Inguinal hernia is one of the most common pediatric surgeries. Effective and safe pain management causes fewer side effects and enables faster hospital discharge. It is also important in overcoming chronic pain in the late postoperative period.

Transversus abdominis plane block (TAPB) has emerged as a safe, simple, and inexpensive modality incorporated into many enhanced recovery pathways to achieve narcotic-sparing analgesia after bariatric surgery. TAPB was first performed through the lumbar triangle of Petit in 2001. Since that time, both ultrasound-guided (US) and laparoscopic (LAP) TAPBs have been developed to aid in proper identification of the correct plane and minimize peritoneal penetration.

Enrollment: 66 patients

Sex: All

Ages: 2 months to 7 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: 2 months to 7 years old
• Both sexes.
• American Society of Anesthesiologists (ASA) I-II.
• Schedule for elective unilateral inguinal hernia repair.

Exclusion criteria

• Patients with history of allergy.
• Hepatic and renal failure.
• Previous inguinal surgery.
• Block contraindications (e.g., infection at the site of block, bleeding disorder, or abnormalities of the sacrum).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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66 participants in 3 patient groups

Ultrasound-guided transversus abdominis plane block

Active Comparator group

Description:

This group will receive Ultrasound-guided transversus abdominis plane block by using 1 ml/kg of bupivacaine 0.25% with a maximum volume of 20 mL as a control group.

Treatment:

Procedure: Ultrasound-guided transversus abdominis plane block

Drug: Bupivacaine

Laparoscopic-assisted transversus abdominis plane block

Experimental group

Description:

Patients will receive Laparoscopic-assisted transversus abdominis plane block by using 1 ml/kg of bupivacaine 0.25% with a maximum volume of 20 mL.

Treatment:

Procedure: Laparoscopic-assisted transversus abdominis plane block

Drug: Bupivacaine

Laparoscopic-assisted intraperitoneal instillation

Experimental group

Description:

This group will receive Laparoscopic-assisted intraperitoneal instillation by using 1 ml/kg of bupivacaine 0.25% with a maximum volume of 20 mL will be instilled into the peritoneal cavity immediately after gas insufflation.

Treatment:

Procedure: Laparoscopic-assisted intraperitoneal instillation

Drug: Bupivacaine