Context: The transversus abdominis plane (TAP) block is a new regional anaesthesia technique applicable to infants and children.
Objective(s): The present study was designed to evaluate the analgesic efficacy of ultrasound-guided TAP block with high volume local anaesthetic (0.5 ml kg) during the first 24 h after surgery in children undergoing inguinal hernia repair.
Design: Randomised comparative study.
Setting: Gaziantep University Hospital between December 2010 and May 2011.
Patients or other participants: Fifty-seven children between 2 and 8 years of age undergoing unilateral inguinal hernia repair were randomised to TAP block (group T, n = 29) or to wound infiltration (group C, n = 28).
Intervention(s): A TAP block using ultrasound guidance with 0.25% levobupivacaine 0.5 ml kg(-1) or wound infiltration with 0.2 ml kg(-1) 0.25% levobupivacaine, was performed on the same side as the hernia under general anaesthesia.
Main outcome measures: Time to first analgesic, cumulative number of doses of analgesic, pain scores and adverse effects were assessed over the course of 24 h.
Results: The time to first analgesic (mean ± SD) was significantly longer in group T than in group C (17 ± 6.8 vs. 4.7 ± 1.6 h, respectively; P < 0.001). Thirteen (45%) patients in group T did not require any analgesic within the first 24 h. The cumulative number of doses of analgesic was significantly lower in group T than in group C (1.3 ± 1.2 vs. 3.6 ± 0.7, respectively, P < 0.001). Pain scores were significantly different between the groups at all time points except at 1, 20 and 24 h (P < 0.001).
Conclusion: Ultrasound-guided TAP block with high volume (0.5 ml kg) 0.25% levobupivacaine provides prolonged postoperative analgesia and reduced analgesic use without any clinical side-effects after unilateral hernia repair in children.
Trial registration: ACTRN12611000585921 (7/06/2011) from Australian New Zealand Clinical Trials Registry.