Analgesic Efficacy of Ultrasound-guided Transversus Abdominis Plane Block for Postoperative Analgesia in Children Undergoing Oblique Inguinal Hernia Repair

doi:10.3877/cma.j.issn.1673-5250.2014.01.010

Objective

The present study was designed to evaluate the analgesic efficacy of ultrasound-guided transverse abdominis plane (TAP) block in children undergoing oblique inguinal hernia repair.

Methods

A total of 80 cases from June 2012 to January 2013 in People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine between 1 and 5 years old, American Society of Anesthesiologists physical statusⅠ, who were undergoing unilateral oblique inguinal hernia repair were randomly (according to random list generated by a computer) divided into TAP block group (research group, n=40) and caudal block group (control group, n=40) . General anaesthesia was induction and maintain with sevoflurane via laryngeal mask airway. A TAP block using ultrasound guidance with 0.25% ropivacaine 0.5 mL/ kg or caudal block with 0.25% ropivacaine 1 mL/ kg, was performed on the same side as the hernia. Main outcome measures includes time to first analgesic, the number of patients required rescue analgesia, pain scores and adverse effects. The age、body mass, etc of general clinic data of 2 groups had no significant difference (P >0.05) . The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine. Informed consent was obtained from the parents of each participating patient.

Results

The time to first analgesic was significantly longer in research group than in control group {18.5 h [95%CI (16.4-20.5)] vs．8.7 h [95%CI (6.3-11.1)]} (P<0.001) ．A significantly less number of patients required rescue analgesia in research group than in control group [17(42.5%) vs． 32(80.0%)], (P<0.05) ．There were 5(12.5%) patients with motor block in control group and the incidence of other adverse effects was similar in both groups (P >0.05) .

Conclusions

Ultrasound-guided TAP block provides prolonged postoperative analgesia and reduced analgesic dosis and adverse effect after unilateral hernia repair in children.

Key words: Ultrasound-guided, Postoperative care, Analgesia, Child

表1 两组患儿一般临床资料比较（±s）

Table 1 Comparison of general clinic datas between two groups （±s）

组别	n	年龄(岁)	体质量(kg)	手术时间(min)	麻醉时间(min)
研究组	40	2.8±0.8	13.4±2.5	32.6 ± 3.7	45.5±4.1
对照组	40	2.6 ± 0.9	13.9±2.8	35.1±3.2	47.6±4.3
t		1.092	0.587	0.671	0.818
P		0.347	0.695	0.514	0.423

表1 两组患儿一般临床资料比较（±s）

Table 1 Comparison of general clinic datas between two groups （±s）

组别	n	年龄(岁)	体质量(kg)	手术时间(min)	麻醉时间(min)
研究组	40	2.8±0.8	13.4±2.5	32.6 ± 3.7	45.5±4.1
对照组	40	2.6 ± 0.9	13.9±2.8	35.1±3.2	47.6±4.3
t		1.092	0.587	0.671	0.818
P		0.347	0.695	0.514	0.423

图1 两组术后有效镇痛时间比较

Figure 1 Comparison of effectively postoperative analgesia time between two groups

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