Is ultrasound-guided transversus abdominis plane block in providing analgesia in pediatric cases safe and efficient?: A retrospective study

Objective: The use of high or insufficient doses of analgesics in pediatric cases unfavorably affects the patient’s health in the postoperative period. Ultrasound-guided transversus abdominis plane (TAP) block is used in the management of postoperative pain in pediatric cases. The present study aims to evaluate the efficacy of ultrasound-guided TAP block in pediatric patients using a mixture of lidocaine and bupivacaine. Methods: The medical records of cases, who underwent surgery for the repair of the inguinal hernia and undescended testis using ultrasound-guided TAP block in the department of pediatric surgery, were retrospectively reviewed (28 cases). The study included ASA I-II pediatric cases aged 2-12 years. The amount of drug administered while performing USG-guided TAP block, time to first analgesic use in the postoperative period, pain score and the amount of first analgesic administration were recorded. The satisfaction of the surgeon and patient’s companion was evaluated. Results: A p-value <0.05 was considered statistically significant. The findings showed that pain score was the lowest in the group with the highest patient’s companion and physician satisfaction score, and the highest in group with the lowest satisfaction score and the difference was statistically significant (p<0.001). The satisfaction of the physicians (p=0.010) and the patient’s companion (p=0.027) increased with increasing drug volume. Conclusions: The volume of 0.4 ml.kg-1 (50:50 1% lidocaine and 2.5% bupivacaine) achieved the best physician and patient’s companion satisfaction and the longest duration of analgesia in pediatric cases undergoing surgery for the repair of the inguinal hernia and undescended testis. The lack of any complications in the present study suggests that USG-guided TAP block is a safe procedure in pediatric patients in experienced hands. Further studies are required.