TAP Block or Wound Infiltration for Laparoscopic Pediatric Appendectomy: a Pilot Study

Ospedale di Circolo - Fondazione Macchi

Status: Unknown

Conditions: Anesthesia, Conduction; Laparoscopy; Child, Preschool; Appendectomy

Treatments: Procedure: LIA local infiltration; Procedure: General anesthesia; Drug: Postperative analgesia; Procedure: TAP Block

Study type: Interventional

Funder types: Other

Identifiers

NCT04294537

VARPON001

Details and patient eligibility

About

Effectiveness of the TAP block compared to wound infiltration in controlling pain after laparoscopic appendectomy in children

Full description

Laparoscopic appendectomy is one of the main emergency surgical procedures performed in children.

The available local anesthesia techniques include wound infiltration or "wall" blocks such as the TAP (transversus abdominis plane) block.

The greater evidence on the adult population suggests that both techniques are valid for pain control in the immediate postoperative period, although wall blocks can guarantee a more prolonged analgesic effect over time.

The evidence on the pediatric population, on the other hand, is less strong and sometimes conflicting: therefore, the objective of our study is to verify the efficacy of TAP block compared to wound infiltration in the control of postoperative pain after appendectomy in pediatric patients.

Enrollment: 20 estimated patients

Sex: All

Ages: 3 to 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged between 3 and 16 years, candidates for laparoscopic appendectomy for suspected acute appendicitis.
• ASA physical status Class I and II
• Informed consent signed by parents / legal guardians

Exclusion criteria

• severe obesity (BMI> 95th percentile for age and weight)
• perforated appendicitis
• paralytic ileum
• non-stabilized neuropathies
• allergy to local anesthetics or analgesics used in the study protocol.
• patients on chronic opiate treatment
• need for perioperative hospitalization in intensive care with sedation and / or mechanical ventilation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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20 participants in 2 patient groups

TAP block

Experimental group

Description:

Bilateral ultrasound-guided single-shot TAP block with 0,15% levobupivacaine 0,75 mg/kg per side.

Treatment:

Procedure: TAP Block

Procedure: General anesthesia

Drug: Postperative analgesia

LIA - local wound infiltration

Active Comparator group

Description:

Wound infiltration with 0,5% levobupivacaine 1.5 mg/kg

Treatment:

Procedure: General anesthesia

Drug: Postperative analgesia

Procedure: LIA local infiltration