Postoperative Pain Clinical Trial
Official title:
Transversus Abdominis Plane Block for Pain Relieve in Children Undergoing Inguinal Surgical Procedures: How Does it Compare With the "Gold Standard" Caudal Blockade
For surgery in the region of the lower abdominal wall the administration of local anesthetic
drugs in the epidural space via the caudal route is the preferentially used technique since
several decades.
The transversus abdominis plane (TAP) block features the advantages of a peripheral nerve
blockade. The aim of this study is to evaluate potential differences in the effectiveness of
postoperative analgesia and to test the hypotheses that the duration of pain relieve ist
prolonged after a TAP block when compared with an epidural technique.
Caudal block (CB) is the gold standard technique for analgesia in children undergoing
surgical interventions in the groin.
Although the efficacy and the safety of this technique is high, nonetheless, there are
several caveats such as unwarranted motor blockade of the lower limbs and disturbances of
the bladder function, potentially resulting in delayed demission in the ambulatory setting.
The effect of the blockade wears off within 4-5h post-block, making the administration of
additional pain medication necessary.
Peripheral nerve blockades (PNB) are an alternative to CB and have a prolonged duration of
the analgesic effect. More recently, an alternative method to block neural structures which
innervate lower abdominal wall has been described; the transverse abdominal plane block. The
ultrasound guided technique improves the safety of margin. However, although this new
technique seems to offer substantial advantages so far only experience from small case
series are available. In particular, the TAP block has not been compared in a systematic
trial with the "gold standard", the caudal block.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Treatment
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