Transversus Abdominis Plane Versus Caudal Block for Pediatrics
Status:
Completed
Trial end date:
2015-07-01
Target enrollment:
Participant gender:
Summary
The transversus abdominis plane (TAP) block is a relatively simple technique that provides
myocutaneous anesthesia that, as part of a multimodal analgesic treatment, may be useful in
the prevention and treatment of parietal postoperative pain.
Initial experience with ultrasound TAP block demonstrated efficacy of the echo guided
technique in different surgical procedures such as cesarean section, appendicectomy,
laparoscopic cholecystectomy, infra umbilical surgery in adult and pediatric patients.
Recently published clinical trials suggest that TAP block may represents an effective
alternative to epidural anesthesia but further studies in larger population are necessary.
Transversus-abdominis plane (TAP) block was found to increase analgesic consumption low
thoracic-epidural analgesia (TEA) in ischemic heart disease patients after abdominal
laparotomy (2). Others found comparable results between continuous transversus abdominis
plane technique and epidural analgesia in regard to pain, analgesic use and satisfaction
after abdominal surgery(3). The TAP block affords effective analgesia with opioid sparing
effects, technical simplicity, and long duration of action. Some disadvantages include the
need for bilateral block for midline incisions and absence of effectiveness for visceral pain
(4). TAP block has been associated with good pain relief and decreased intraoperative and
postoperative opioids requirements after laparoscopic surgery (5). The analgesic efficacy of
the TAP block has been demonstrated in prospective randomized trials compared with placebo,
in different surgical procedures such as abdominal surgery, hysterectomy, retro pubic
prostatectomy, Caesarean section, laparoscopic cholecystectomy, and appendicectomy (6, 7, 8,
9, 5 and 10 respectively). All these studies have reported superiority of the TAP block in
terms of reduction in visual analogue scale scores and morphine consumption. In this study
the investigators try to compare Transversus Abdominis Plane (TAP) blocks versus caudal block
for postoperative pain control after lower abdominal surgeries in pediatrics.