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A PRELIMINARY STUDY OF POSTERIOR ULTRASOUND - GUIDED TRANSVERSUS ABDOMINIS PLAIN BLOCK VERSUS WOUND INFILTRATION FOR OPEN APPENDECTOMY SURGERY IN CHILDREN
Author(s): ,
Gkliatis, E.
Affiliations:
Ag. Sofia Children's Hospital, Anesthesiology, Athens, Greece
,
Garini, E.
Affiliations:
Ag. Sofia Children's Hospital, Anesthesiology, Athens, Greece
,
Brattou, P.
Affiliations:
Ag. Sofia Children's Hospital, Anesthesiology, Athens, Greece
,
Makris , A.*
Affiliations:
General Hospital "Asklepieion Voulas", Anesthesiology, Athens, Greece
Evangelopoulou, E.
Affiliations:
Ag. Sofia Children's Hospital, Anesthesiology, Athens, Greece
ESRA Academy. Makris A. Sep 13, 2017; 190834
Topic: Paediatric Population
Dr. Alexandros Makris
Dr. Alexandros Makris

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Abstract
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Background and Aims:

Ultrasound-guided Posterior Transversus Abdominis Plane Block (USGTAPB) is a safe and effective method for lower abdominal wall surgery. In Agia Sofia paediatric hospital, wound infiltration is the standard local analgesia procedure. We present a randomized preliminary study evaluating USGTAPB over surgeon delivered wound infiltration, for children undergoing open appendectomies.

Methods:

After informed consent, 28 children ASA I-II, aged 5-11 years-old, were included in the study. Total dose of 0.3 ml/kg Ropivacaine 0.2% was delivered: in Group TAP (n=14) by US-guided posterior TAPB and in Group INF (n=14) by surgeon delivered wound infiltration. The anaesthetists / surgeons team was kept the same throughout the study and the evaluator was blinded to the intervention. All patients received paracetamol 15 mg/kg q.i.d. as were also prescribed iv tramadol 1 mg/kg on pain score>4.

Outcome measures were pain at the PACU (FLACC, FACES or NRS scales) and number of tramadol doses over the first 24 hours.

Results:

Median pain score in the PACU was 0 (0-3) for group TAP vs 2 (0-4) for group INF (P<0.05). No patient in group TAP asked for supplementary analgesia, whilst 43% patients in group INF received one dose of tramadol during the first 24 hours. No complication was recorded in TAP group. One patient in group INF presented PONV.

Conclusions:

From this limited sample of children, posterior TAPB seems to be a safe and effective method, reducing postoperative pain and opioid consumption in open appendectomy.

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