Comparison of the effectiveness of transversalis fascia plane block and transversus abdominis plane block for postoperative analgesia in pediatric lower abdominal surgeries: prospective, single blinded study.

Abstract

Background: Achieving adequate postoperative analgesia in the pediatric age group is also important in terms of future pain perception and chronic pain development in the subsequent period. The primary aim of our study was to compare the effects of Transversus Abdominis Plane (TAP) and Transversalis Fascia Plane (TFP) blocks on pain scores at the 6th postoperative hour in children undergoing lower abdominal surgery. Secondary aims include the observation of pain scores over the first 24 h postoperatively, the duration until the first analgesic requirement, the presence of postoperative nausea and vomiting symptoms, and the satisfaction of parents with the provided analgesia method.

Methods: Patients aged between 1 and 7 years, classified as ASA I-II, who were scheduled for elective surgery for undescended testes and inguinal hernia, were included in our study. The study was designed as a prospective observational study. The patients were divided into two groups: TAP block (n = 42) and TFP block (n = 42). Intraoperative remifentanil consumption, hemodynamic parameters, postoperative FLACC pain scores, analgesic requirements, and the time of the first analgesic need were recorded for 24 h.

Results: A total of 84 patients were included in the study. The groups were similar in terms of demographic data. No difference was found in FLACC pain scores between the groups that received both TAP and TFP blocks in patients followed for 24 h postoperatively (p > 0.05). Intraoperative remifentanil consumption was similar in TAP blocks 74 (20-100) and TFP blocks 40 (24.75-71) µg, (p: 0.268). When calculating based on the first analgesic consumption for TAP and TFP groups, it is found that the median analgesic effect durations were 12 and 9 h, respectively, for the two groups.

Conclusions: In children undergoing lower abdominal surgery, ultrasound-guided TAP and TFP blocks have shown similar effects on pain scores and analgesic requirements for 24 h postoperatively. We believe that both blocks, which we found to provide analgesia without the need for opioids after lower abdominal surgery in pediatric patients, can be safely used in this patient group.

Clinical trials registration: NCT06530147.