Laparoscopic vs Ultrasound-Guided Transversus Abdominis Plane Block vs Laparoscopic Intraperitoneal Instillation of Local Anesthetic in Pediatrics Undergoing Inguinal Hernia Repair: A Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Bupivacaine
- Conditions
- Laparoscopic
- Sponsor
- Tanta University
- Enrollment
- 66
- Locations
- 1
- Primary Endpoint
- Total postoperative pethidine consumption
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
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.
Detailed 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.
Investigators
ِAhmed Mohamed Ibrahim
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine
Tanta University
Eligibility Criteria
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).
Arms & Interventions
Ultrasound-guided transversus abdominis plane block
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.
Intervention: Bupivacaine
Ultrasound-guided transversus abdominis plane block
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.
Intervention: Ultrasound-guided transversus abdominis plane block
Laparoscopic-assisted transversus abdominis plane block
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.
Intervention: Laparoscopic-assisted transversus abdominis plane block
Laparoscopic-assisted transversus abdominis plane block
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.
Intervention: Bupivacaine
Laparoscopic-assisted intraperitoneal instillation
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.
Intervention: Laparoscopic-assisted intraperitoneal instillation
Laparoscopic-assisted intraperitoneal instillation
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.
Intervention: Bupivacaine
Outcomes
Primary Outcomes
Total postoperative pethidine consumption
Time Frame: 24 hours postoperatively
The patient will be given supplementary paracetamol I.V. injection in a dose of 15 mg/kg as routine analgesia. If the FLACC score is \> 3, pethidine 0.5 mg/kg.
Secondary Outcomes
- Post-operative pain scores(24 hours postoperatively)
- Time of first analgesia request.(24 hours postoperatively)
- Incidence of adverse events(24 hours postoperatively)