ORIGINAL ARTICLE
Year : 2009  |  Volume : 3  |  Issue : 1  |  Page : 2-6

Preliminary experience with transversus abdominis plane block for postoperative pain relief in infants and children


Department of Anesthesiology, Chief, Division of Pediatric Anesthesiology, Russell and Mary Shelden Chair in Pediatric Intensive Care Medicine; Professor of Anesthesiology and Child Health, University of Missouri, Department of Anesthesiology, 3W-27G HSC, One Hospital Drive, Columbia, Missouri 65212.

Correspondence Address:
Joseph D Tobias
Department of Anesthesiology, Chief, Division of Pediatric Anesthesiology, Russell and Mary Shelden Chair in Pediatric Intensive Care Medicine; Professor of Anesthesiology and Child Health, University of Missouri, Department of Anesthesiology, 3W-27G HSC, One Hospital Drive, Columbia, Missouri 65212.

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.51827

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Background. In the adult population, analgesia following lower abdominal surgery and laparoscopic procedures can be provided by a transversus abdominis plane (TAP) block where local anesthetic is placed between the internal oblique and the tranversus abdominis muscles using an injection in the triangle of Petit. We present preliminary experience with the postoperative analgesic efficacy of TAP block in pediatric patients. Patients and Methods. Ten pediatric patients, ranging in age from 10 months to 8 years were reviewed. Using ultrasound guidance, a TAP block was placed on both sides with 0.3 mL/kg of 0.25% bupivacaine with epinephrine 1:200,000 after the completion of the surgical procedure. The surgical procedures included ureteral reimplantation (n=3), colostomy takedown (n=2), pelvic laparoscopy for evaluation of abdominal pain (n=2), laparoscopic appendectomy (n=2), and bilateral inguinal hernia repair (n=1). Results. In 8 of 10 patients, the TAP block was judged to be successful as no postoperative analgesic agents were required for the initial 7-11 postoperative hours. Four patients required no intravenous opioids postoperatively and were treated with oral opioids as outpatients. The other 4 patients required 0.15 0.04 mg/kg of morphine during the first 24 postoperative hours. The TAP block was judged to be unsuccessful in 2 patients who required intravenous opioids during their immediate postoperative course, starting at 2 and 3 hours postoperatively. These two patients required 0.3-0.4 mg/kg of morphine during the first 24 postoperative hours. No adverse effects related to TAP block were identified. Conclusion. Our preliminary experience suggests that TAP block provides effective analgesia following umbilical and lower abdominal surgery in infants and children.


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