Ultrasound Verification of Laparoscopic-Assisted Transversus Abdominis Plane Blocks in Children Undergoing Laparoscopic Procedures.
J Laparoendosc Adv Surg Tech A
; 32(3): 325-329, 2022 Mar.
Article
in En
| MEDLINE
| ID: mdl-34962162
ABSTRACT
Purpose:
Ultrasound-guided transversus abdominis plane (TAP) blocks have been demonstrated to decrease postoperative pain; however, laparoscopic-assisted TAP (L-TAP) blocks have not been well studied in children. Our study utilized intraoperative ultrasound to verify whether surgeon-administered blocks using only laparoscopic visualization were reliably delivered into the correct plane. Materials andMethods:
Patients undergoing laparoscopic procedures were enrolled to receive L-TAP blocks. Preblock and postblock ultrasounds were performed to document the plane of local anesthetic delivery. Ultrasound images were reviewed by two blinded anesthesiologists to determine whether the L-TAP block was administered into the desired plane.Results:
Fifty-one patients were enrolled. The average age was 5.9 years (range 2 days to 17 years) and the mean weight was 25.4 kg (range 2.64-118.8 kg). The most common procedures were inguinal hernia repair (n = 19), appendectomy (n = 10), and gastrostomy-tube placements (n = 13). Nine surgeons performed 93 L-TAP blocks (average 10.3 blocks/surgeon). Ultrasound confirmed distribution in the correct plane in 53.5/93 blocks (57.5%; 58.0% for attending surgeons), with 77.4% concurrence between the anesthesiologist reviewers.Conclusion:
L-TAP achieves delivery of local anesthetic into the correct tissue plane in over half the cases with minimal training. Further studies are needed to examine the effect of L-TAP blocks on reducing postoperative pain in pediatric patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Laparoscopy
/
Nerve Block
Limits:
Child
/
Child, preschool
/
Humans
Language:
En
Journal:
J Laparoendosc Adv Surg Tech A
Year:
2022
Document type:
Article
Affiliation country:
United States