Preemptive analgesic efficacy of ultrasound-guided transversalis fascia plane block in children undergoing inguinal herniorrhaphy: a randomized, double-blind, controlled study

Ibrahim Abdelbaser, Nabil A Mageed, El-Sayed M El-Emam, Mahmoud M ALseoudy, Mohamed M Elmorsy, Ibrahim Abdelbaser, Nabil A Mageed, El-Sayed M El-Emam, Mahmoud M ALseoudy, Mohamed M Elmorsy

Abstract

Background: Surgical repair of congenital inguinal hernia results in significant postoperative discomfort and pain. The aim of the current study was to evaluate the pre-emptive analgesic efficacy of a transversalis fascia plane (TFP) block after pediatric inguinal herniorrhaphy.

Methods: Forty-four patients aged 12 to 60 months who underwent unilateral inguinal herniorrhaphy were enrolled. Four patients were excluded, and the remaining were allocated to the control group and the TFP block group. In the TFP block group, 0.4 mL/kg bupivacaine 0.25% was instilled in the plane between the transversus abdominis and transversalis fascia, while in the control group 0.9% saline was used instead of bupivacaine. The collected data were the total dose of paracetamol consumed during the first 12 h postoperatively, the postoperative Face, Leg, Activity, Cry, Consolability (FLACC) pain score, time to first use of rescue analgesia, number of patients required additional postoperative analgesics, and parents' satisfaction.

Results: The median paracetamol consumption was significantly lower in the TFP block group than in the control group, and FLACC pain scores were significantly lower for all study times in the TFP block group with higher parental satisfaction scores than those for the control group. The number of patients who required additional analgesics was significantly lower in the TFP block group than in the control group.

Conclusions: The use of a TFP block decreases postoperative analgesic consumption and postoperative pain intensity after pediatric inguinal herniorrhaphy. Future studies with larger sample size are required to evaluate the actual complications rate of TFP block.

Keywords: Acetaminophen; Analgesia; Child; Fascia; Herniorrhaphy; Postoperative pain.

Conflict of interest statement

Conflicts of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
CONSORT flow diagram. TFP: transversalis fascia plane.
Fig. 2.
Fig. 2.
(A) Ultrasound images of transversalis fascia plane before local anesthetic injection. (B) Ultrasound images of transversalis fascia plane after local anesthetic injection. EO: external oblique muscle, IO: internal oblique muscle, TA: transversus abdominis muscle, QL: quadratus lumborum muscle, LA: local anesthetic.
Fig. 3.
Fig. 3.
Five-point Likert scale for evaluating parental satisfaction. Values are presented as median and interquartile range. *P < 0.05, statistically significantly different from the control group.

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Source: PubMed

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