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The Efficacy of Different Bupivacaine Concentrations in Pediatric Patients Undergoing Transversus Abdominis Plane Block

Not Applicable
Completed
Conditions
Transversus Abdominis Plane Block
Interventions
Drug: 1 mg.kg-1 bupivacaine 0.25%
Drug: 1 mg.kg-1 bupivacaine 0.125%
Registration Number
NCT04202367
Lead Sponsor
Istanbul University
Brief Summary

This study is designed to compare the analgesic efficacy of different bupivacaine concentrations in pediatric patients undergoing ultrasound-guided transversus abdominis plane (TAP) block for unilateral inguinal hernia repair. In recruited 74 patients; Group 1 (n:37) received 1 mg/kg bupivakain 0.25% and Group 2 (n: 37) received 1 mg/kg bupivakain 0.125% for ultrasound-guided TAP block following standard general anaesthesia induction. FLACC (Face, Legs, Activity, Cry, Consolability) behavioral pain assessment scale was used for evaluating patients' postoperative pain levels at 15-, 30-, 45-minute and 1-, 2-, 6-, 24-hour. Tramadol 1 mg/kg was administered intravenously as rescue analgesic when FLACC score was ≥4. Total analgesic requirement, length of hospital stay and side effects were recorded.

Detailed Description

Transversus abdominis plane (TAP) block is a safe and effective analgesia technique for paediatric patients. This study is designed to compare the analgesic efficacy of different bupivacaine concentrations in paediatric patients undergoing ultrasound-guided TAP blocks for unilateral inguinal hernia repair surgery. Seventy-four patients aging between 1 and 8 years, undergoing unilateral inguinal hernia surgery, were enrolled for this study after obtaining Institutional Ethics Committee approval and written informed consents from parents or legal guardians (2016/1281). Group 1 (n:37) received 1 mg/kg bupivakain 0.25% and Group 2 (n: 37) received 1 mg/kg bupivakain 0.125% for ultrasound-guided TAP block following standard general anaesthesia induction. All patients received remifentanil 0,1 μg/kg/h infusion and paracetamol 15 mg/kg intraoperatively, and paracetamol 4x15 mg/kg per day postoperatively. FLACC (Face, Legs, Activity, Cry, Consolability) behavioral pain assessment scale was used for evaluating patients' postoperative pain levels at 15-, 30-, 45-minute and 1-, 2-, 6-, 24-hour. Tramadol 1 mg/kg was administered intravenously as rescue analgesic when FLACC score was ≥4. Total analgesic requirement, length of hospital stay and side effects were recorded.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
74
Inclusion Criteria
  • American Society of Anesthesiologists (ASA) status I/II
  • Children between 1 to 8 years of age
  • Patients undergoing unilateral inguinal hernia repair surgery
Exclusion Criteria
  • Denial of parents
  • Patients who are allergic to local anesthetics

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TAP block with 1 mg.kg-1 bupivacaine 0.25%1 mg.kg-1 bupivacaine 0.25%Patients had 1 mg.kg-1 bupivacaine 0.25% with US-guided TAP block
TAP block with 1 mg.kg-1 bupivacaine 0.125%1 mg.kg-1 bupivacaine 0.125%Patients had 1 mg.kg-1 bupivacaine 0.125% with US-guided TAP block
Primary Outcome Measures
NameTimeMethod
FLACC pediatric pain scoresup to 24 hours

It corporates five categories of behavior, each scored on 0-2 point scale so that total score ranges from 0-10.

Secondary Outcome Measures
NameTimeMethod
Total analgesic requirementup to 24 hours

Tramadol

First analgesic requirement timeup to 24 hours

Duration of postoperative analgesia

Incidence of side effectsup to 24 hours

Nausea, vomiting, respiratory depression

The length of hospital stayup to 24 hours

Hospitalisation hours

Incidence of complicationsup to first week.

Hemotoma, infection

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