Çocuklarda ultrason eşliğinde transversus abdominis plane bloğun intraoperatif anesteziye katkısı- randomize kontrollü çalışma

Amaç: Bu çalışmanın amacı,çocuklarda intravenöz ketamin sedasyonuyla desteklenen transversus abdominis plane(TAP) bloğun intraoperatif anesteziye ve analjeziye katkısını araştırmaktır. Yöntem: 2-6 yaş arası toplam 60 hasta çalışmaya dahil edilmiştir. Hastalar 3 gruba ayrıldı; TAP blok ve ketamin grubu; larıngeal maske takılarak(LMA) TAP blok yapılan ve sevofluran grubu; LMA ve sevofluran grubu. Peroperatif kalp hızları(KH), ortalama arter basınçları(OAB), kullanılan sevofluran miktarı, postoperatif ağrı skorları, kurtarma analjezisine ihtiyaç olan çocuk sayısı, ilk analjeziye ihtiyaç duyulan zaman kaydedildi. Bulgular: Hastaların yaş ortalaması 4±1,1 idi. İki blok grup arasında KH ve OAB açısından fark yoktu; sadece sevofluran grubunda KH daha yüksek ve OAB daha düşüktü. TAP bloğu tarafından desteklenen grupta, kullanılan sevofluran miktarı azalmıştı(p

Contribution of ultrasound-guided transversus abdominis plane block to intraoperative anesthesia in children - randomized controlled study

Objective: The aim of this study is to investigate the contribution of transversus abdominis plane (TAP) block supportedby intravenous ketamine sedation in children on intraoperative anesthesia and analgesia.Method: A total of 60 patients aged between 2 and 6 years, were included in the study. The patients were divided in threegroups;the TAP block and ketamine group; the TAP block by inserting the laryngeal mask(LMA) and sevoflurane grup;and the LMA and sevoflurane group. Peroperative heart rates(HR), mean arterial pressures(MAP), amount of sevofluraneused, postoperative pain scores, number of children needing rescue analgesia, time required for the first analgesia wererecorded.Results: Of the patients average age was 4 ± 1.1. There was no difference between the two block groups, in terms of HRand MAP; HR were higher and MAP were lower in the only sevoflurane group.In the group supported by a TAP block,the amount of sevoflurane used decreased(p

PDF

___

1. Lacroix F. Epidemiology and morbidity of regional anaesthesia in children. Curr Opin Anaesthesiol. 2008;21(3):345-9.
2. Willschke H, Marhofer P, Machata AM, Lonnqvist PA. Current trends in paediatric regional anaesthesia. Anaesthesia. 2010;65 Suppl 1:97-104.
3. Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis. Can J Anaesth. 2012;59(8):766-78.
4. Schaeffer E, Millot I, Landy C, Nadaud J, Favier JC, Plancade D. Another use of continuous transversus abdominis plane (TAP) block in trauma patient: pelvic ring fractures. Pain Med. 2014;15(1):166-7.
5. Niraj G, Kelkar A, Fox AJ. Application of the transversus abdominis plane block in the intensive care unit. Anaesth Intensive Care. 2009;37(4):650- 2.
6. Walter CJ, Maxwell-Armstrong C, Pinkney TD, Conaghan PJ, Bedforth N, Gornall CB, et al. A randomised controlled trial of the efficacy of ultrasound-guided transversus abdominis plane (TAP) block in laparoscopic colorectal surgery. Surg Endosc. 2013;27(7):2366-72.
7. Stuart-Smith K. Hemiarthroplasty performed under transversus abdominis plane block in a patient with severe cardiorespiratory disease. Anaesthesia. 2013;68(4):417-20.
8. Tekelioglu UY, Demirhan A, Sit M, Kurt AD, Bilgi M, Kocoglu H. Colostomy with Transversus Abdominis Plane Block. Turk J Anaesthesiol Reanim. 2015;43(6):424-6.
9. Alsadek WM, Al-Gohari MM, Elsonbaty MI, Nassar HM, Alkonaiesy RM. Ultrasound guided TAP block versus ultrasound guided caudal block for pain relief in children undergoing lower abdominal surgeries. Egyptian Journal of Anaesthesia. 2015;31(2):155-60.
10. McDonnell JG, O'Donnell B, Curley G, Heffernan A, Power C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 2007;104(1):193-7.
11. O'Donnell BD, McDonnell JG, McShane AJ. The transversus abdominis plane (TAP) block in open retropubic prostatectomy. Reg Anesth Pain Med. 2006;31(1):91.
12. Kim SH, Chun DH, Chang CH, Kim TW, Kim YM, Shin YS. Effect of caudal block on sevoflurane requirement for lower limb surgery in children with cerebral palsy. Paediatr Anaesth. 2011;21(4):394-8.
13. Tanaka M, Mori N, Murakami W, Tanaka N, Oku K, Hiramatsu R, et al. [The effect of transversus abdominis plane block for pediatric patients receiving bone graft to the alveolar cleft]. Masui. 2010;59(9):1185-9.
14. Carney J, Finnerty O, Rauf J, Curley G, McDonnell JG, Laffey JG. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial. Anesth Analg. 2010;111(4):998- 1003.
15. Ramzy Shaaban A. Ultrasound guided transversus abdominis plane block versus local wound infiltration in children undergoing appendectomy: A randomized controlled trial. Egyptian Journal of Anaesthesia. 2014;30(4):377- 82.
16. Dahmani S, Stany I, Brasher C, Lejeune C, Bruneau B, Wood C, et al. Pharmacological prevention of sevoflurane- and desflurane-related emergence agitation in children: a meta-analysis of published studies. Br J Anaesth. 2010;104(2):216- 23.