Clinical application of different approaches of ultrasound guided transversus abdominis plane block in children undergoing laparoscopic groin surgery / 中国医师杂志

ABSTRACT

Objective To investigate the analgesic efficacy of ultrasound guided transversus abdominis plane block and to compare the efficacy of posterior approach and medial approach of ultrasound guided transversus abdominis plane block (TAPB) in providing postoperative analgesia after children laparoscopic groin surgery.Methods Eligible children 2 ～ 4 years old (n =60),American society of anesthesiologists (ASA) I,undergoing elective laparoscopic unilateral groin surgery were randomly assigned into posterior approach group (Group P),medial approach group (Group M) and control group (Group C).Many parameters were measured and recorded during the study,including funk sedation scores,intraoperative circulation monitoring at time points of T1 (before induction),T2 (skin incision) and T3 (skin closure),length of surgery,the time from post anesthesia care unit (PACU) arrival to the first obtainable pain score,length of PACU stay,modified-children's hospital of eastern ontario pain scale(m-CHEOPS),pediatric anesthesia emergence delirium (PAED) scores,number of children with sufentanil administered in PACU,number of people occurred nausea and vomiting,and satisfaction of parents.Results There were no statistically significant difference in general characteristics,basic emotion score,duration of surgery,the time from PACU arrival to first obtainable score,haemodynamic parameter at T1 and satisfaction of parents among groups P,M,and C.However,the m-CHEOPS scores at the time points of first obtainable,10 min,the number of children received sufentanil administration,PAED scores and haemodynamic parameter at T2 and T3 were significantly lower in groups P and M than in group C.There were no significant difference in parameters mentioned above between groups P and M.Conclusions Ultrasound guided transversus abdominis plane block could provide efficient and secure postoperative analgesia for children undergoing laparoscopic groin surgery.Both posterior approach and medial approach are ideal options.