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Clinical Effectiveness of Transversus Abdominis Plane (TAP) Block versus Local Anesthesia Wound Infiltration for Postoperative Pain Relief After Laparoscopic Appendicectomy in Children: A Study Protocol for a Multicenter Double-Blind Randomized Controlled Phase III Trial.
Bloy, Geoffrey; Jurine, Amelie; Chaussy, Yann; Auber, Frederic; Guinot, Pierre-Gregoire; Bouhemad, Belaid; Francois, Michel; Vettoretti, Lucie; Pili-Floury, Sebastien; Nguyen, Maxime; Besch, Guillaume.
Afiliação
  • Bloy G; CHU Besançon, Département d'Anesthésie Réanimation Chirurgicale, Besançon, F-25000, France.
  • Jurine A; CHU Besançon, Département d'Anesthésie Réanimation Chirurgicale, Besançon, F-25000, France.
  • Chaussy Y; Université de Franche-Comté, CHU Besançon, SINERGIES, Service de Chirurgie Pédiatrique, Besançon, F-25000, France.
  • Auber F; Université de Franche-Comté, CHU Besançon, SINERGIES, Service de Chirurgie Pédiatrique, Besançon, F-25000, France.
  • Guinot PG; University of Burgundy and Franche-Comté, Dijon University Hospital, INSERM LNC UMR1231, FCS Bourgogne Franche-Comté LipSTIC LabEx, Dijon, F-21000, France.
  • Bouhemad B; University of Burgundy and Franche-Comté, Dijon University Hospital, INSERM LNC UMR1231, FCS Bourgogne Franche-Comté LipSTIC LabEx, Dijon, F-21000, France.
  • Francois M; Université de Bourgogne, CHU Dijon, Service de Chirurgie Pédiatrique, Dijon, F-21000, France.
  • Vettoretti L; CHU Besançon, Département d'Anesthésie Réanimation Chirurgicale, Besançon, F-25000, France.
  • Pili-Floury S; Université de Franche-Comté, CHU Besançon, SINERGIES, Département d'Anesthésie Réanimation Chirurgicale, Besançon, F-25000, France.
  • Nguyen M; University of Burgundy and Franche-Comté, Dijon University Hospital, INSERM LNC UMR1231, FCS Bourgogne Franche-Comté LipSTIC LabEx, Dijon, F-21000, France.
  • Besch G; Université de Franche-Comté, CHU Besançon, SINERGIES, Département d'Anesthésie Réanimation Chirurgicale, Besançon, F-25000, France.
J Pain Res ; 17: 1547-1553, 2024.
Article em En | MEDLINE | ID: mdl-38699069
ABSTRACT

Purpose:

Postoperative pain relief after laparoscopic appendicectomy is a key determinant of early rehabilitation in children. Recent guidelines recommend performing either a transversus abdominis plane (TAP) block or local anesthesia (LA) wound infiltration as part of multimodal postoperative analgesia after appendectomy. To date, the clinical effectiveness of TAP block versus LA wound infiltration has never been compared. The hypothesis of this study is that the TAP block may provide a greater opioid-sparing effect after laparoscopic appendicectomy in children than LA wound infiltration. Study Design and

Methods:

We designed a multicenter double-blind randomized controlled phase III trial and aim to include 110 children who undergo laparoscopic appendicectomy. Children are randomized to receive either TAP block (TAP group) or LA wound infiltration (infiltration group). Multimodal analgesia is standardized in the two groups using the same protocol, which includes the stepwise prescription of paracetamol, phloroglucinol, ketoprofene, and nalbuphine according to the hetero-evaluation of pain performed by the nurses who were blinded to the treatment allocated using the validated FLACC scale. The primary outcome is the total dose of nalbuphine administered within 24 hours after surgery.

Discussion:

No study has specifically compared the clinical effectiveness of TAP block versus LA wound infiltration for postoperative pain relief after laparoscopic appendectomy in children. This paper describes the protocol for a randomized trial that addresses this issue. The results of this trial will be useful for editing guidelines with a higher level of evidence on this topic.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article