THE EFFICACY OF TRANSVERSE ABDOMINIS PLANE (TAP) BLOCK IN CHILDREN UNDERGOING HYDROCELECTOMY AND/OR HERNIA REPAIR
Surgical incision and tissue trauma result in postoperative pain. Neonates, infants and children frequently undergo painful procedures, but adequate pediatric pain management can prove challenging. Children do not report pain as effectively or descriptively as adults, and they may be especially prone to the side effects of commonly used medications including opiates and non-steroidal anti-inflammatory drugs. Regional pain blocks, especially when done under ultrasound guidance, have proven to be extremely effective at reducing postoperative pain and improving patient satisfaction. The transverse abdominis plane (TAP) block, has been shown to be effective in controlling pain associated with surgery involving the abdomen. Ultrasound allows for precise blockade making the TAP block an excellent choice for multimodal pain management for procedures involving lower abdominal incisions. At our institution, pain management in children is managed either via oral/parenteral opiates and opiate adjuncts (for instance codeine ± acetaminophen), surgeon-administered field blocks (infiltration of local anesthetics in the general area of incision), or via regional techniques (spinal, epidural, or peripheral nerve blocks). This study is designed to determine if there is improved qualitative and quantitative post-operative pain control in patients receiving preoperative (after induction of anesthesia, and prior to incision) TAP block versus intraoperative peri-incisional, surgeon administered field block.