To compare the effect of M-TAPA block and port-site local anesthetic infiltration onpostoperative pain in pediatric laparoscopic appendectomies. The main questions it aimsto 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.
Not Provided
Procedure: M-TAPA Block
M-TAPA Block; The block will be done by the same experienced anesthesiologist by using
ultrasound(USG) after the surgical intervention is completed.The external oblique,
internal oblique, and transversus abdominis muscles were shown on the costochondral angle
in the sagittal plane at the 10th costal margin by using a high-frequency linear probe.
Bilaterally in the midclavicular line at the level of the 10th rib (arcus costarum),0,5
ml/kg 0.25% Bupivacaine (maximum dose 2mg/kg) was administered to between the upper
fascia of the transversus abdominis muscle and the lower fascia of the costochondral
tissue.
Procedure: Local anesthetic infltration to port sites
Local anesthetic infiltration to port sites; The surgeon infiltrated 0.5 ml/kg of 0.25%
Bupivacaine (maximum dose of 2mg/kg) in the skin, subcutaneous tissue, and muscle fascia
at each of the three laparoscopic port areas at the end of the surgery.
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
Gulhane Training and Research Hospital
Ankara, Kecioren, Turkey
ELA ERTEN, Principal Investigator
Anesthesiology and Reanimation department