Modified Thoracoabdominal Nerve Block(M-TAPA) in Pediatric Laparoscopic Appendectomies

Medical Doctor of Anesthesiology and Reanimation

To compare the effect of M-TAPA block and port-site local anesthetic infiltration on postoperative pain in pediatric laparoscopic appendectomies. The main questions it aims to answer are:

• Is M-TAPA block more effective in reducing pain?
• How M-TAPA block affects the use of rescue analgesics in the postoperative period? Participants will have the same anaesthetic agents during surgery, before extubation they will have same analgesic agent for postoperative pain. Participants in the M-TAPA group will undergo USG-guided M-TAPA block bilaterally with % 0.025 Bupivacaine max dose of 2 mg/kg by the same experienced anesthesiologist before extubation. Participants in the LAI group will be administered 0.025% Bupivacaine at a maximum dose of 2mg/kg divided equally and administered by the surgeon at 3 port entry sites before the patient is extubated.

Inclusion Criteria:

• Patients with American society of Anesthesiologists (ASA) physical status I-II,
• Patients which will undergo Laparoscopic appendectomy due to the diagnosis of acute appendicitis,
• Patients whose parents or legal heirs have consented to participate in the study

Exclusion Criteria:

• Patients with Society of Anesthesiologists (ASA) III-IV status,
• Patients whose parents or legal heirs' disapproval,
• Patients inability to cooperate,
• Patients who have allergy to any of the medications used in the study,
• Patients with perforated appendix
• When the Laparoscopic surgery returns to open shape