Chee Kean CHEN, Shu Ching TEO, Mat Ariffin SAMAN, Vuş Eng PHUI

Analgesic efficacy of transversus abdominis plane block in neonates and early infants for colostomy and reversal of colostomy

Pediyatrik hastalarda ultrason eşliğinde transversus abdominis plan (TAP) bloğu anestezistler arasında popülarite kazanmak- tadır. Kolostomi ve stomanın kapatılması sırasında 10 yenidoğan ve bebekte ultrason eşliğinde TAP bloğu olgu çalışmasını sunuyoruz. Hebbard tarafından tanımlanan klasik TAP uygulandı ve maksimum 1 ml/kg dozda %0.25 levobupivakain enjekte edildi. Yenidoğan Ağrı Ölçeği kullanılarak 24 saat boyunca ağrı skorları değerlendirildi. Hastaların hepsinde minimal hemodi- namik değişikliklerle blok başarılı oldu, ameliyat sırasında ve erken ameliyat sonrası dönemde ilave sistemik analjeziğe gerek duyulmadı. Kolostomi oluşturma ve stomayı kapatma için ultrason eşliğinde TAP bölümoğu güvenli ve etkili analjezi sağlama- da önemli bir role sahiptir.

Yenidoğanlar ve küçük çocuklarda kolostomi ve kolostominin kapatılması sırasında uygulanan transversus abdominis plan bloğun analjezik etkinliği

The application of ultrasound-guided transversus abdominis plane (TAP) block in paediatric population is gaining popularity among anaesthetists. We present a case series of ultrasound-guided TAP block in ten neonate and infants undergoing colos- tomy and reversal of stoma. Classical TAP as described by Hebbard was carried out and a maximum dosage of 1ml/kg of 0.25% levobupivacaine was injected. Pain score was assessed using Neonatal Infant Pain Scale for 24 hours. In all patients, the block was successful with minimal hemodynamic changes intraoperatively and no additional systemic analgesia was needed intra- operative and immediate postoperatively. Ultrasound-guided TAP block has an important role in providing safe and effective analgesia for colostomy creation and reversal of stoma surgeries in paediatric population.

PDF

___

1. Macrae WA. Chronic pain after surgery. Br J Anaesth 2001;87(1):8898. 2. Akkaya T, Ozkan D. Chronic post-surgical pain. Agri 2009;21(1):19. 3. Coté CJ, Karl HW, Notterman DA, Weinberg JA, McCloskey C. Adverse sedation events in pediatrics: analysis of medi- cations used for sedation. Pediatrics 2000;106(4):63344. 4. Kain ZN, Mayes LC, Caldwell-Andrews AA, Karas DE, Mc- Clain BC. Preoperative anxiety, postoperative pain, and be- havioral recovery in young children undergoing surgery. Pediatrics 2006;118(2):6518. 5. Hebbard P, Fujiwara Y, Shibata Y, Royse C. Ultrasound-guid- ed transversus abdominis plane (TAP) block. Anaesth In- tensive Care 2007;35(4):6167. 6. Lawrence J, Alcock D, McGrath P, Kay J, MacMurray SB, Dul- berg C. The development of a tool to assess neonatal pain. Neonatal Netw 1993;12(6):5966. 7. Uguralp S, Mutus M, Koroglu A, Gurbuz N, Koltuksuz U, Demircan M. Regional anesthesia is a good alternative to general anesthesia in pediatric surgery: Experience in 1,554 children. J Pediatr Surg 2002;37(4):6103. 8. Berde CB. Toxicity of local anesthetics in infants and chil- dren. J Pediatr 1993;122(5 Pt 2):1420. 9. Bellieni CV. Pain assessment in human fetus and infants. AAPS J 2012;14(3):45661. 10. Rozen WM, Tran TM, Ashton MW, Barrington MJ, Ivanu- sic JJ, Taylor GI. Refining the course of the thoracolumbar nerves: a new understanding of the innervation of the an- terior abdominal wall. Clin Anat 2008;21(4):32533. 11. Niraj G, Searle A, Mathews M, Misra V, Baban M, Kiani S, et al. Analgesic efficacy of ultrasound-guided transversus ab- dominis plane block in patients undergoing open appen- dicectomy. Br J Anaesth 2009;103(4):6015. 12. Gürkan Y, Tekin M, Yirmibeşoğlu AO, Aysu Salviz E. Bilateral transversus abdominus plane block for incisional hernia repair. Agri 2011;23(3):1345. 13. Chen CK, Tan PC, Phui VE, Teo SC. A comparison of analgesic efficacy between oblique subcostal transversus abdominis plane block and intravenous morphine for laparascopic cholecystectomy. A prospective randomized controlled trial. Korean J Anesthesiol 2013;64(6):5116. 14. McDonnell JG, Curley G, Carney J, Benton A, Costello J, Maharaj CH, et al. The analgesic efficacy of transversus ab- dominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg 2008;106(1):18691. 15. Tekin M, Gurkan Y, Solak M, Toker K. Ultrasound-guided bilateral transversus abdominis plane block in a 2-month- old infant. J Anesth 2009;23(4):6434. 16. Jacobs A, Thies KC. Ultrasound-guided transversus abdom- inis plane block for reversal of ileostomy in a 2-kg prema- ture neonate. Paediatr Anaesth 2009;19(12):12378. 17. Jacobs A, Bergmans E, Arul GS, Thies KC. The transversus abdominis plane (TAP) block in neonates and infants - re- sults of an audit. Paediatr Anaesth 2011;21(10):107880. 18. Tsui BC, Suresh S. Ultrasound imaging for regional anes- thesia in infants, children, and adolescents: a review of cur- rent literature and its application in the practice of neur- axial blocks. Anesthesiology 2010;112