Blockade of thoracoabdominal nerves through perichondrial approach (TAPA) versus transversus abdominis plane block (TAP) for postoperative analgesia in pediatric abdominal surgeries
A randomized controlled trial
Keywords:
truncal blocks, pediatric abdominal surgery, postoperative pain, multimodal analgesia, TAP block, TAPA block, ultrasoundAbstract
Background: Inadequate pain control after pediatric abdominal surgery complicates patient recovery and may lead to postoperative respiratory dysfunction. Multimodal analgesia using truncal blocks can be used to achieve better analgesic effect and improves patent outcome. This study aimed to compare the postoperative analgesic efficacy of transversus abdominis plane (TAP) block and thoracoabdominal nerves through perichondrial approach (TAPA) block in pediatric patients undergoing abdominal surgeries. Material and methods: A total of 100 pediatric patients undergoing elective abdominal surgery were randomly allocated equally into two groups intraoperatively where first group received transversus abdominis plane (TAP) block and second group received thoracoabdominal nerves through perichondrial approach (TAPA) block. Results: Patients in both groups showed statistically comparable (P > 0.05) stable hemodynamic characteristics during intraoperative period. Also, patients in both groups showed no statistically significant difference difference (P > 0.05) in the analgesic parameters including time to first analgesic request and postoperative pain score. Conclusion: Both TAP and TAPA blocks are equally effective in managing pain after abdominal surgery in pediatric population.
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Tulgar S, Senturk O, Selvi O , Balaban O, Ahiskalioglu A, Thomas D.T, et al. Perichondral approach for blockage of thoracoabdominal nerves: anatomical basis and clinical experience in three cases. Journal of clinical anesthesia. 2019 May; 54: 8-10.
Koh W.U & Lee J.H. Ultrasound-guided truncal blocks for perioperative analgesia. Anesthesia and Pain Medicine. 2018 Apr; 13(2): 128-142.
Abo El-hassn A.K, Mansour H.S, & Mohamed M. Abdominal truncal blocks in Children Undergoing Laparoscopic Surgery.Minia Journal of Medical Research. 2020 Jul; 31(3): 304-307.
Martín M.T.F, Álvarez S.L & Herrero M.A.P. Serratus-intercostal interfascial block as an opioid-saving strategy in supra-umbilical open surgery. Revista Española de Anestesiología y Reanimación. 2018 Oct; 65(8): 456-460.
Sahin L., Soydinc M.H, Sen E, Cavus O, & Sahin M. Comparison of 3 different regional block techniques in pediatric patients: A prospective randomized single-blinded study. Saudi medical journal. 2017 Aug; 38(9): 952-959.
Mai C.L, Young M.J, & Quraishi, S.A. Clinical implications of the transversus abdominis plane block in pediatric anesthesia. Pediatric Anesthesia. 2012 Sep; 22(9): 831-840.
Coté C.J, Notterman D.A, Karl H.W, Weinberg J.A, & McCloskey C. Adverse sedation events in pediatrics: a critical incident analysis of contributing factors. Pediatrics. 2000 Apr;105(4): 805-814.
Fredrickso M.J, & Seal P. Ultrasound-guided transversus abdominis plane block for neonatal abdominal surgery. Anaesthesia and intensive care. 2009 May; 37(3): 469-472.
Balaban O, Tulgar S, Ahiskalioglu A, Thomas D.T, & Aydin T. Blockage of thoracoabdominal nerves through perichondrial approach (TAPA) for surgical anesthesia after failed erector spinae plane block in mini-laparatomy. Journal of clinical anesthesia. 2019 Aug; 55: 74-75.
ErtÜRk T, & Ersoy A. Postoperative analgesic efficacy of the thoracoabdominal nerves block through perichondrial approach (TAPA) and modified-TAPA for laparoscopic cholecystectomy: a randomized controlled study. Signa Vitae. 2022 Mar;18(2): 114-120.
Jacobs A, Bergmans E, Arul G.S, & Thies K.C. The transversus abdominis plane (TAP) block in neonates and infants–results of an audit. Pediatric Anesthesia. 2011 Oct; 21(10): 1078-1080.
Masters O.W, & Thies K.C. TAP block and low-dose NCA for major upper abdominal surgery. Paediatric anaesthesia. 2011 Jan; 21(1): 87-88.
Charlton S, Cyna A.M, Middleton P., & Griffiths J.D. Perioperative transversus abdominis plane (TAP) blocks for analgesia after abdominal surgery. Cochrane Database of Systematic Reviews. 2010 Dec;8(12).
O'Donnell B.D, McDonnell J.G, McShane A.J. The transversus abdominis plane (TAP) block in open retropubic prostatectomy. Regional anesthesia and pain medicine. 2006 Jan; 31(1): 91.
McDonnell J.G, O'Donnell B.D, Curley G, Heffernan A, Power C, & Laffey J.G. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesthesia & Analgesia. 2007 Jan; 104(1): 193-197.
Hebbard P, Fujiwara Y, Shibata Y, & Royse C. Ultrasound-guided transversus abdominis plane (TAP) block. Anaesthesia and intensive care. 2007 Aug; 35(4): 616-618.
Hebbard P. Subcostal transversus abdominis plane block under ultrasound guidance. Anesthesia & Analgesia. 2008 Feb; 106(2): 674-675.
Hardy C.A. Transverse abdominis plane block in neonates: is it a good alternative to caudal anesthesia for postoperative analgesia following abdominal surgery? Paediatric anaesthesia. 2009 Jan; 19(1): 56.
Suresh S. & Chan V.W.S. Ultrasound guided transversus abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance. Pediatric Anesthesia. 2009 Apr; 19(4), 296-299.
Carney J, Finnerty O, Rauf J, Curley G, McDonnell J.G, & Laffey J.G. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial. Anesthesia & Analgesia. 2010 Oct; 111(4): 998-1003.
Ludot H, Testard A, Ferrand I, Chaouadi D, Labrousse M, & Malinovsky J.M. 596 Analgesic Efficacy of Transversus Abdominis Plane Block (TABP) in Children Undergoing Appendicectomy. Regional Anesthesia & Pain Medicine. 2008 Sep; 33(Suppl 1): e224.
Mukhtar K, & Singh S. Transversus abdominis plane block for laparoscopic surgery. British journal of anaesthesia.2009 Jan; 102(1), 143-144.
Karnik P.P, Dave N.M, Shah H.B, & Kulkarni K. Comparison of ultrasound-guided transversus abdominis plane (TAP) block versus local infiltration during paediatric laparoscopic surgeries. Indian journal of anaesthesia.2019 May; 63(5): 356-360.
Bergmans E, Jacobs A, Desai R, Masters O.W, & Thies, K.C. Pain relief after transversus abdominis plane block for abdominal surgery in children: A service evaluation. Local and regional anesthesia. 2015 Apr; 8: 1-6.
Brogi E, Kazan R, Cyr S, Giunta F, & Hemmerling, T.M. Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2016 Oct; 63(10): 1184-1196.
Tanaka N, Yagi Y, Aikawa K, & Morimoto Y. Anesthetic management by blockage of thoracoabdominal nerves through perichondrial approach (TAPA) for open nephrectomy in a pediatric patient with Wilms tumor. Journal of clinical anesthesia. 2020 Feb; 59: 51-52.Widana, I.K., Sumetri, N.W., Sutapa, I.K.,
Suryasa, W. (2021). Anthropometric measures for better cardiovascular and musculoskeletal health. Computer Applications in Engineering Education, 29(3), 550–561. https://doi.org/10.1002/cae.22202
Fitria, F., Ahmad, M., Hatijar, H., Argaheni, N. B., & Susanti, N. Y. (2022). Monitoring combination of intermittent auscultation and palpation of contractions on oxygen saturation of newborns. International Journal of Health & Medical Sciences, 5(3), 221-227. https://doi.org/10.21744/ijhms.v5n3.1930
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