- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01559740
Transversus Abdominis Plane Blocks for Infants and Children for Postoperative Pain Control
March 19, 2012 updated by: Ann & Robert H Lurie Children's Hospital of Chicago
Transversus Abdominis Plane Blocks for Infants and Children for Postoperative Pain Control: Is it the Concentration or Volume of Local Anesthetic Solution That Improves Analgesia?
After undergoing hernia surgery, hydrocelectomy or lower abdominal surgery, a child may experience some amount of pain in the post-operative period.
As part of the anesthesia technique, the investigators routinely provide a nerve block done on the abdominal wall that will provide pain relief for at least 10 hours postoperatively.
This is referred to as a TAP block.
The purpose of this study is to determine if the nerve block performed with local anesthetic solution using a regular concentration solution vs. a diluted solution may offer different durations of pain relief.
Study Overview
Detailed Description
Children undergoing groin surgery or abdominal surgery under general anesthesia are offered pain relief postoperatively using regional anesthesia techniques including a central block like a caudal block, or peripheral nerve blocks including ultrasound guided ilioinguinal nerve block or transversus abdominis plane (TAP) block.
The TAP block, a peripheral block of the thoraco-lumbar nerve roots as they exit between the internal oblique and the transversus abdominis muscle can be easily visualized using ultrasound guidance.
The TAP block has been used for analgesia following major surgeries including lower abdominal surgeries and in newborn infants following major abdominal procedures including colostomy placement.1
The purpose of this study is to determine if two different concentrations of bupivacaine delivered at a total dose of 1 mL/kg offer similar or altered analgesia, i.e., does the concentration of the anesthetic matter more than the volume of local anesthetic while performing a TAP block in children undergoing groin surgery.
Parents and the investigators will be blinded to the solution used for the TAP block.
The solution will be drawn up by an investigator who is not a participant in the patient's care in a sterile fashion.
Study Type
Interventional
Enrollment (Actual)
36
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Illinois
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Chicago, Illinois, United States, 60614
- Children's Memorial Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
No older than 8 years (Child)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Children under 8 years of age presenting for hernia repair, hydrocelectomy or lower abdominal surgery
- Estimated operative time approximately 3 hours
- American Society of Anesthesiologists Classification ASA I or II
- Parental consent to be included in the study
Exclusion Criteria:
Any contraindications to local anesthesia but not limited to
- Local infection of the abdominal wall.
- Allergy to amide local anesthetics
- History of significant cardiac disease or uncontrolled seizures.
- Allergy to rescue analgesia including acetaminophen and or hydromorphone.
- Neonates under 28 days.
- Inability for the family to complete the postoperative questionnaire
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 0.25% Bupivacaine
All children will receive a single dose of 1 mcg/kg of Fentanyl intravenously prior to incision.
Group TAP 1 receiving a TAP block with 0.25% bupivacaine with 1:200,000 epinephrine at a dose of 1 mL/kg.
|
This is being used as the local anesthetic for the TAP blocks at either 0.25% or 0.125%.
The block will be done once during the procedure.
|
Experimental: 0.125% Bupivacaine
All children will receive a single dose of 1 mcg/kg of Fentanyl intravenously prior to incision.
Group TAP 2 will receive a TAP block with a total dose of 1 mL/kg given at a concentration of 0.125% bupivacaine with 1:200,000 epinephrine.
|
This is being used as the local anesthetic for the TAP blocks at either 0.25% or 0.125%.
The block will be done once during the procedure.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
TAP Block Concentration of Bupivacaine that Reduces Postoperative Pain
Time Frame: Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
The difference in concentrations will be measured by using FLACC score every 5 mins for one hour after surgery in the Post Anesthesia Care Unit.
Blood pressuer and heart rate will also be recorded.
|
Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Dose of rescue medications given between the two groups
Time Frame: Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
The dose of pain medications administered will be recorded by the nurse or study coordinator while in the hospital.
The caregiver will record the dose of pain medications administered in a caregiver questionnaire sheet.
|
Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
Number of rescue medications given between the two groups
Time Frame: Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
The number of pain medications administered will be recorded by the nurse or study coordinator while in the hospital.
The caregiver will record the number of pain medications administered in a caregiver questionnaire sheet.
|
Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
Time the rescue medications were administered between the two groups
Time Frame: Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
The time pain medications administered will be recorded by the nurse or study coordinator while in the hospital.
The caregiver will record the time pain medications administered in a caregiver questionnaire sheet.
|
Participants will be followed for the duration of anesthesia and after surgery, an average of 48 hours
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- 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 Jan;104(1):193-7. doi: 10.1213/01.ane.0000250223.49963.0f. Erratum In: Anesth Analg. 2007 May;104(5):1108.
- Suresh S, Chan VW. Ultrasound guided transversus abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance. Paediatr Anaesth. 2009 Apr;19(4):296-9. doi: 10.1111/j.1460-9592.2009.02958.x.
- Bielsky A, Efrat R, Suresh S. Postoperative analgesia in neonates after major abdominal surgery: 'TAP' our way to success! Paediatr Anaesth. 2009 May;19(5):541-2. doi: 10.1111/j.1460-9592.2009.02988.x. No abstract available.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
July 1, 2010
Primary Completion (Actual)
August 1, 2010
Study Registration Dates
First Submitted
March 12, 2012
First Submitted That Met QC Criteria
March 19, 2012
First Posted (Estimate)
March 21, 2012
Study Record Updates
Last Update Posted (Estimate)
March 21, 2012
Last Update Submitted That Met QC Criteria
March 19, 2012
Last Verified
March 1, 2012
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CMH IRB 2009-13887
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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