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THE ROLE OF TAP BLOCK IN CHILDREN UNDERGOING APPENDICECTOMY IN A PAEDIATRIC REFERENCE HOSPITAL
ESRA Academy. Martins A. Sep 8, 2016; 138338; 0173 Topic: Paediatric Population
Ana Martins
Ana Martins

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Abstract
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Background and Aims:

TAP block is emerging as an effective peripheral nerve block for postoperative pain management of abdominal surgeries.

The aim of this study was the evaluation of the postoperative analgesic efficacy of TAP block comparing it with intravenous analgesia.Methods:

Retrospective study in children undergoing open appendicectomy between December 2014 and August 2015. Two groups were identified: children submitted to a TAP block and those who received intravenous tramadol or morphine (by perfusion syringe or DIB) for postoperative analgesia.

The TAP block group received ultrasound-guided right side TAP block using ropivacaine 0,1% or 0,2% 0,2ml/Kg after anaesthetic induction. All patients received acetaminophen 15mg/Kg and metamizol 20mg/Kg                                                                                   in 48h postoperative period.

Postoperative pain intensity was registered according to FLACC score at 0, 12, 24 and 48 hours.

We assessed the cases of no controlled pain and postoperative nausea or vomiting, and time to hospital discharge.

Results:

From 261 patients, 155 were male, aging between 1 and 19 years. 177 children classified as ASA I. TAP block was done in 52 patients (19,9%). Intravenous tramadol was administered in 67 patients and 27 received  intravenous morphine. Intravenous postoperative analgesia was associated with low intensity of postoperative pain at 12h (p<0,05; 95% IC; OR: -0,224-0,168).

There were no significant differences in number of cases of no controlled pain, nausea and vomiting. There were no complications attributable to the TAP block.

Conclusions:

In our patients, TAP block didn’t show advantages over intravenous postoperative analgesia as the latter was associated with better postoperative pain control at 12h.

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