Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Comparison of Postoperative Analgesic Efficacy Between Ultrasonography-Guided Quadratus Lumborum and Transversus Abdominis Plane Blocks in Infants Undergoing Inguinal Hernia Surgery: Randomized Controlled Trial
Kasık Fıtığı Ameliyatı Olan İnfantlarda Ultrasonografi Eşliğinde Yapılan Quadratus Lumborum Bloğu ve Transversus Abdominis Plan Bloğunun Postoperatif Analjezik Etkinliğinin Karşılaştırılması: Randomize Kontrollü Bir Çalışma
Pınar SAYINa, Hacer Şebnem TÜRKa, Mustafa ALTINAYa, Melis TÜRKEL ÖZKANa, Serkan İSLAMOĞLUa, Surhan ÇINARa
aClinic of Anesthesiology and Reanimation, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
Turkiye Klinikleri J Med Sci. 2022;42(2):87-94
doi: 10.5336/medsci.2022-87968
Article Language: EN
Full Text
ABSTRACT
 Objective: We compared the analgesic efficacy of ultrasonography (USG)-guided quadratus lumborum (QL) and transversus abdominis plane (TAP) blocks in infants undergoing elective unilateral inguinal hernia surgery (IHS). Material and Methods: This single-center, randomized, single-blind, 2-arm clinical trial included 60 infants undergoing elective IHS (aged 1 month to 1 year) with ASA I'II. The patients were randomized into QL block (Group A) and TAP block (Group B) groups. For both groups, 0.3 mL/kg of 0.25% bupivacaine was injected under USG guidance. Age, sex, weight, anesthesia duration (min), surgery duration (min), and recovery duration (min) were recorded. The heart rate (HR) was recorded at baseline, after anesthesia induction, and at 15 and 30 min after the blocks. Postoperatively, patients were evaluated based on their Face, Legs, Activity, Cry, and Consolability (FLACC) scores at 0, 1, 2, 6, 12, and 24 h. We also recorded the first analgesic duration, analgesic requirement, rescue analgesic requirement, and complications. The primary outcome of the study was FLACC score. Results: Sixty patients completed the study protocol. There were no significant differences between the groups in terms of age, sex, weight, anesthesia duration, surgery duration, recovery duration, or FLACC score or HR in the first 24 h postoperatively. The analgesic requirement, first analgesic requirement time, and rescue analgesic requirement were not significantly different between the groups (p>0.05 for all comparisons). Conclusions: QL and TAP blocks showed similar analgesic efficacy in infants undergoing IHS.

Keywords: Anesthesia, conduction; ultrasound; interventional; pediatric patients; quadratus lumborum; transversus abdominis plane block
ÖZET
 Amaç: Bu çalışmada, elektif tek taraflı kasık fıtığı cerrahisi uygulanan infantlarda ultrasonografi (USG) kılavuzluğunda quadratus lumborum (QL) bloğu ve transversus abdominis plan (TAP) bloğunun analjezik etkinliğini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Bu çalışma, ASA I-II durumu olan ve elektif kasık fıtığı cerrahisi uygulanan 60 infant hastanın (yaş aralığı 1 ay ila 1 yıl) dâhil edildiği tek merkezli, randomize, tek kör, 2 kollu klinik bir çalışmadır. Hastalar QL (Grup A) ve TAP blok (Grup B) gruplarına randomize edildi. Her iki gruba da USG eşliğinde %0,25 (0,3 mL/kg) bupivakain enjekte edildi. Yaş, cinsiyet, kilo, anestezi süresi (dk), ameliyat süresi (dk) ve derlenme süreleri (dk) kaydedildi. Kalp atım hızları (KH) bazal, anestezi sonrası, 15 ve 30. dk bloklar için kaydedildi. Ameliyat sonrası hastalar 0, 1, 2, 6. 12 ve 24. saatlerde Yüz, Bacaklar, Hareket, Ağlama, Avutabilme Davranışsal [Face, Legs, Activity, Cry, and Consolability (FLACC)] Skalası ile değerlendirildi. İlk analjezik ihtiyacı süresi, analjezik gereksinimleri, kurtarıcı analjezik gereksinimleri ve komplikasyonları kaydedildi. Çalışmanın birincil sonucu, FLACC skorlarının karşılaştırılması idi. Bulgular: Altmış hasta çalışma protokolünü tamamladı. Gruplar arasında yaş, cinsiyet, ağırlık, anestezi süresi, ameliyat süresi ve derlenme süresi ilk 24 saatteki FLACC skorları ve KH açısından anlamlı bir farklılık gözlenmedi. Analjezik gereksinimi, ilk analjezik gereksinimi ve kurtarma analjezik gereksinimleri gruplar arasında istatistiksel olarak anlamlı fark gözlenmedi (tüm karşılaştırmalar için p>0,05). Sonuç: Kasık fıtığı cerrahisi uygulanan infantlarda QL bloğu ve TAP bloğu benzer analjezik etkinlik gösterdi.

Anahtar Kelimeler: Anestezi; konduksiyon; ultrason; girişimsel; pediatrik hastalar; quadratus lumborum; transversus abdominis plan bloğu
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