TAP Block or Wound Infiltration for Laparoscopic Pediatric Appendectomy: a Pilot Study

TAP Block or Wound Infiltration for Laparoscopic Pediatric Appendectomy: Prospective Randomized Study

Effectiveness of the TAP block compared to wound infiltration in controlling pain after laparoscopic appendectomy in children

Laparoscopic appendectomy is one of the main emergency surgical procedures performed in children.

The available local anesthesia techniques include wound infiltration or "wall" blocks such as the TAP (transversus abdominis plane) block.

The greater evidence on the adult population suggests that both techniques are valid for pain control in the immediate postoperative period, although wall blocks can guarantee a more prolonged analgesic effect over time.

The evidence on the pediatric population, on the other hand, is less strong and sometimes conflicting: therefore, the objective of our study is to verify the efficacy of TAP block compared to wound infiltration in the control of postoperative pain after appendectomy in pediatric patients.

Inclusion Criteria:

• Patients aged between 3 and 16 years, candidates for laparoscopic appendectomy for suspected acute appendicitis.
• ASA physical status Class I and II
• Informed consent signed by parents / legal guardians

Exclusion Criteria:

• severe obesity (BMI> 95th percentile for age and weight)
• perforated appendicitis
• paralytic ileum
• non-stabilized neuropathies
• allergy to local anesthetics or analgesics used in the study protocol.
• patients on chronic opiate treatment
• need for perioperative hospitalization in intensive care with sedation and / or mechanical ventilation