Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases
Yıl: 2023 Cilt: 53 Sayı: 1 Sayfa Aralığı: 374 - 381 Metin Dili: İngilizce DOI: 10.55730/1300-0144.5594 İndeks Tarihi: 29-03-2023
Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases
Öz: Background/aim: Transversus abdominis plane (TAP) block is a method for postoperative pain management. Studies on children are gradually increasing. The aim of this retrospective study was to evaluate effectiveness of TAP block on pain control, its side effects, and parental satisfaction levels in children. Material and methods: Study included patients operated between January 2019 and December 2020 in Gazi University Faculty of Medicine. Total of 97 patients (35 girls, 62 boys) between 5 and 18 years who had an ultrasound guided TAP block for lower abdominal or inguinal surgery were examined retrospectively. TAP block application time, hemodynamic variables, postoperative pain scores, postoperative analgesic requirement, sex, surgical history and satisfaction levels were evaluated. Results: The average application time of TAP block was 9.48 ± 3.4 and the time between TAP block and surgical incision was 12.06 ± 6.1 min. Pain scores in postanesthesia care unit (PACU) and at the postoperative first hour decreased as the time between TAP block and surgical incision increased (p < 0.05). Girls have higher pain scores at PACU than boys (p < 0.05). Previous surgical history increased postoperative 1st hour pain scores (OR: 13.8; 95% CI 1.7–113.3; p = 0.01). There was a significant negative correlation between pain scores at PACU, postoperative 1st, 2nd, 4th, 6th, 12th and satisfaction levels (r = –0.45, r = –0.56, r = –0.60, r = –0.54, r = –0.52, r = –0,43, respectively, p < 0.05). Conclusion: Ultrasound-guided TAP blocks can be performed safely in children in lower abdominal surgeries. However, the efficacy of TAP block on late term postoperative pain scores is limited. Time interval between the TAP block and the incision, sex, and pain memory, as well as other factors that may improve the quality of TAP block should be considered.
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- 1. Vittinghoff M, Lönnqvist PA, Mossetti V, Heschl S, Simic D et al. Postoperative pain management in children: Guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative). Pediatric Anesthesia 2018; 28 (6): 493-506. https://doi. org/10.1111/pan.13373
- 2. Fortier MA, Maclaren JE, Martin SR, Perret-Karimi D, Kain ZN. Pediatric pain after ambulatory surgery: where’s the medication? Pediatrics 2009; 124 (4): 588-595. https://doi. org/10.1542/peds.2008-3529
- 3. Chakraborty A, Goswami JPatro V. Ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a pediatric patient. Anesthesia and analgesia case reports 2015; 4 (3): 34-36. https://doi.org/ 10.1213/ XAA.0000000000000090
- 4. Wu Y, Liu F, Tang H, Wang Q, Chen L et al. The analgesic efficacy of subcostal transversus abdominis plane block compared with thoracic epidural analgesia and intravenous opioid analgesia after radical gastrectomy. Anesthesia and Analgesia 2013; 117 (2): 507-513. https://doi.org/10.1213/ANE.0b013e318297fcee
- 5. Tran T, Ivanusic J, Hebbard P, Barrington M. Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study. British Journal of Anaesthesia 2009; 102 (1): 123-127. https://doi.org/10.1093/ bja/aen344
- 6. Støving K, Rothe C, Rosenstock CV, Aasvang EK, Lundstrøm LH et al. Cutaneous sensory block area, muscle-relaxing effect, and block duration of the transversus abdominis plane block: a randomized, blinded, and placebo-controlled study in healthy volunteers. Regional Anesthesia and Pain Medicine 2015; 40(4): 355-362. https://doi.org/10.1097/AAP.0000000000000252
- 7. Fredrickson MJ, Paine C, Hamill J. Improved analgesia with the ilioinguinal block compared to the transversus abdominis plane block after pediatric inguinal surgery: a prospective randomized trial. Pediatric Anesthesia 2010; 20(11): 1022- 1027. https://doi.org/10.1111/j.1460-9592.2010.03432.x
- 8. Ipek CB, Kara D, Yilmaz S, Yeşiltaş S, Esen A et al. Comparison of ultrasound-guided transversus abdominis plane block, quadratus lumborum block, and caudal epidural block for perioperative analgesia in pediatric lower abdominal surgery. Turkish Journal of Medical Sciences 2019; 49(5): 1395-1402. https://doi.org/10.3906/sag-1812-59
- 9. Thalayasingam P, Weberguide D. Acute Pain Management in Children. In: Sims C, Weber D, Johnson C (editors). A Guide to Pediatric Anesthesia. 2 nd ed. Cham, Switzerland: Springer; 2020. pp. 199-220.
- 10. Sims C, Farrel T. An overview of pediatric anesthesia. In: Sims C, Weber D, Johnson C (editors). A Guide to Pediatric Anesthesia. 2nd ed. Cham, Switzerland: Springer; 2020. pp. 1-26.
- 11. Mogil JS. Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon. Nature Reviews Neuroscience 2012; 13 (12): 859-866. https://doi.org/10.1038/ nrn3360
- 12. Miller MM, Williams AE, Zapolski TC, Rand KL, Hirsh AT. Assessment and treatment recommendations for pediatric pain: the influence of patient race, patient gender, and provider pain-related attitudes. The Journal of Pain 2020; 21 (1-2): 225- 237. https://doi.org/10.1016/j.jpain.2019.07.002
- 13. Kozlowski LJ, Kost-Byerly S, Colantuoni E, Thompson CB, Vasquenza KJ et al. Pain prevalence, intensity, assessment and management in a hospitalized pediatric population. Pain Management Nursing 2014; 15(1): 22-35. https://doi. org/10.1016/j.pmn.2012.04.003
- 14. Peters JW, Schouw R, Anand KJ, Van Dijk M, Duivenvoorden HJ et al. Does neonatal surgery lead to increased pain sensitivity in later childhood? Pain 2005; 114 (3): 444-454. https://doi. org/10.1016/j.pain.2005.01.014
- 15. Noel M, Chambers CT, Mcgrath PJ, Klein RM, Stewart SH. The influence of children’s pain memories on subsequent pain experience. Pain 2012; 153 (8): 1563-1572. https://doi. org/10.1016/j.pain.2012.02.020
- 16. Coughlin SM, Karanicolas PJ, Emmerton-Coughlin H, Kanbur B, Kanbur S et al. Better late than never? Impact of local analgesia timing on postoperative pain in laparoscopic surgery: a systematic review and metaanalysis. Surgical Endoscopy 2010; 24 (12): 3167-3176. https://doi.org/10.1007/s00464-010-1111-1
- 17. Møiniche S, Kehlet H, Dahl JB. A qualitative and quantitative
- systematic review of preemptive analgesia for postoperative pain relief: the role of timing of analgesia. Anesthesiology 2002; 96 (3): 725-74. https://doi.org/10.1097/00000542-200203000- 00032
- 18. Bergmans E, Jacobs A, Desai R, Masters OW, Thies KC. Pain relief after transversus abdominis plane block for abdominal surgery in children: A service evaluation. Local and Regional Anesthesia 2015; 8: 1-6. https://doi.org/10.2147/LRA.S77581
- 19. Dwivedi D, Sud S, Singh S, Sharma R. Surgeon-assisted continuous transversus abdominis plane block a feasible option for perioperative pain relief in pediatric surgical patients with spinal deformities. Journal of Indian Association of Pediatric Surgeons 2020; 25 (2): 126-128. https://doi.org/10.4103/jiaps. JIAPS_90_19
- 20. Hamill JK, Rahiri JL, Liley A, Hill AG. Rectus sheath and transversus abdominis plane blocks in children: a systematic review and meta analysis of randomized trials. Pediatric Anesthesia 2016; 26 (4): 363-371. https://doi.org/10.1111/ pan.12855
- 21. Suresh S, Chan VW. Ultrasound guided transversus abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance. Pediatric Anesthesia 2009; 19 (4): 296-299. https://doi.org/10.1111/ j.1460-9592.2009.02958.x
- 22. Taenzer AH, Herrick M, Hoyt M, Ramamurthi R, Walker B et al. Variation in pediatric local anesthetic dosing for peripheral nerve blocks: an analysis from the pediatric regional anesthesia network (PRAN). Regional Anesthesia and Pain Medicine 2020; 45 (12): 964-969. https://doi.org/10.1136/rapm-2020- 101720
- 23. Long JB, Birmingham PK, De Oliveira Jr GS, Schaldenbrand KM, Suresh S. Transversus abdominis plane block in children: a multicenter safety analysis of 1994 cases from the PRAN (Pediatric Regional Anesthesia Network) database. Anesthesia and Analgesia 2014; 119 (2): 395-399. https://doi.org/10.1213/ ANE.0000000000000284
- 24. Manatakis DK, Stamos N, Agalianos C, Karvelis MA, Gkiaourakis M et al. Transient femoral nerve palsy complicating “blind” transversus abdominis plane block. Case Reports in Anesthesiology 2013; 2013: 874215 https://doi. org/10.1155/2013/874215
- 25. Carney J, Mcdonnell JG, Ochana A, Bhinder R, Laffey JG. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesthesia and Analgesia 2008; 107 (6): 2056- 2060. https://doi.org/10.1213/ane.0b013e3181871313
- 26. Farooq M, Carey M. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Regional Anesthesia and Pain Medicine 2008; 33 (3): 274-275. https://doi.org/10.1016/j.rapm.2007.11.009
- 27. Vial F, Mory S, Guerci P, Grandjean B, Petry L et al. Evaluating the learning curve for the transversus abdominal plane block: a prospective observational study. Canadian Journal of Anaesthesia 2015; 62 (6): 627. https://doi.org/10.1007/s12630- 015-0338-7
- 28. Hebbard PD. Transversalis fascia plane block, a novel ultrasound-guided abdominal wall nerve block. Canadian Journal of Anaesthesia 2009; 56 (8): 618-620. https://doi. org/10.1007/s12630-009-9110-1
- 29. Abdallah F, Laffey J, Halpern S, Brull R. Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis. British Journal of Anaesthesia 2013; 111 (5): 721-735. https://doi.org/10.1093/ bja/aet214
- 30. Abu Elyazed MM, Mostafa SF, Abdullah MA, Eid GM. The effect of ultrasound guided transversus abdominis plane (TAP) block on postoperative analgesia and neuroendocrine stress response in pediatric patients undergoing elective open inguinal hernia repair. Pediatric Anesthesia 2016; 26 (12): 1165-1171. https://doi.org/10.1111/pan.12999
- 31. France CR, Froese SA, Stewart JC. Altered central nervous system processing of noxious stimuli contributes to decreased nociceptive responding in individuals at risk for hypertension. Pain 2002; 98 (1-2): 101-118. https://doi.org/10.1016/S0304- 3959 (01)00477-8
| APA | PAMPAL H, Erel S, turhan s, UĞRAŞ DİKMEN A, Işık B (2023). Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. , 374 - 381. 10.55730/1300-0144.5594 |
| Chicago | PAMPAL HASAN KUTLUK,Erel Selin,turhan semin,UĞRAŞ DİKMEN ASİYE,Işık Berrin Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. (2023): 374 - 381. 10.55730/1300-0144.5594 |
| MLA | PAMPAL HASAN KUTLUK,Erel Selin,turhan semin,UĞRAŞ DİKMEN ASİYE,Işık Berrin Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. , 2023, ss.374 - 381. 10.55730/1300-0144.5594 |
| AMA | PAMPAL H,Erel S,turhan s,UĞRAŞ DİKMEN A,Işık B Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. . 2023; 374 - 381. 10.55730/1300-0144.5594 |
| Vancouver | PAMPAL H,Erel S,turhan s,UĞRAŞ DİKMEN A,Işık B Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. . 2023; 374 - 381. 10.55730/1300-0144.5594 |
| IEEE | PAMPAL H,Erel S,turhan s,UĞRAŞ DİKMEN A,Işık B "Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases." , ss.374 - 381, 2023. 10.55730/1300-0144.5594 |
| ISNAD | PAMPAL, HASAN KUTLUK vd. "Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases". (2023), 374-381. https://doi.org/10.55730/1300-0144.5594 |
| APA | PAMPAL H, Erel S, turhan s, UĞRAŞ DİKMEN A, Işık B (2023). Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. Turkish Journal of Medical Sciences, 53(1), 374 - 381. 10.55730/1300-0144.5594 |
| Chicago | PAMPAL HASAN KUTLUK,Erel Selin,turhan semin,UĞRAŞ DİKMEN ASİYE,Işık Berrin Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. Turkish Journal of Medical Sciences 53, no.1 (2023): 374 - 381. 10.55730/1300-0144.5594 |
| MLA | PAMPAL HASAN KUTLUK,Erel Selin,turhan semin,UĞRAŞ DİKMEN ASİYE,Işık Berrin Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. Turkish Journal of Medical Sciences, vol.53, no.1, 2023, ss.374 - 381. 10.55730/1300-0144.5594 |
| AMA | PAMPAL H,Erel S,turhan s,UĞRAŞ DİKMEN A,Işık B Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. Turkish Journal of Medical Sciences. 2023; 53(1): 374 - 381. 10.55730/1300-0144.5594 |
| Vancouver | PAMPAL H,Erel S,turhan s,UĞRAŞ DİKMEN A,Işık B Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases. Turkish Journal of Medical Sciences. 2023; 53(1): 374 - 381. 10.55730/1300-0144.5594 |
| IEEE | PAMPAL H,Erel S,turhan s,UĞRAŞ DİKMEN A,Işık B "Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases." Turkish Journal of Medical Sciences, 53, ss.374 - 381, 2023. 10.55730/1300-0144.5594 |
| ISNAD | PAMPAL, HASAN KUTLUK vd. "Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases". Turkish Journal of Medical Sciences 53/1 (2023), 374-381. https://doi.org/10.55730/1300-0144.5594 |
