Choose the Best Concentration of Ropivacaine on TAP Block for Open Appendectomy in Children

NCT03005808 — Phase 4, Completed, 40 participants, Hospital Infantil Albert Sabin

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Choose Between Two Different Concentration of Ropivacaine on TAP Block for Children Submitted of Open Appendectomy

RegistryNCT03005808
StatusCompleted
PhasePhase 4
Study typeInterventional; randomized, parallel, masking: single, treatment
Enrollment40 (Actual)
SponsorHospital Infantil Albert Sabin (Other); collaborators: Fortaleza University
ConditionsPain, Postoperative, Appendicitis
InterventionsRopivacaine (Drug)
Datesstart 2015-01-01, primary completion 2016-02-01, completion 2016-11-01, first posted 2016-12-29, last updated 2016-12-30
Locations1 site in Brazil

Related Papers Related Patents Related Grants Related Experts
All trials for Pain, Postoperative All trials for Appendicitis All trials of Ropivacaine

-Summary

Blockage of the transverse abdomen (TAP) promotes excellent analgesia of the abdominal wall and the parietal peritoneum. The TAP block could advange the postoperative pain of Appendectomy in children. The world literature doesn´t focus the best Ropivacaine´s concentration to improve postoperative pain in Appendectomy in children. We propose a randomized trial that compares 3 groups children submitted Appendectomy in children between 6 and 16 years. The control group has received no blockade, the other two groups have received TAP blocks if ropivacaine 0,25% and 0,5% 0.4ml/kg.

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+Detailed description

Blockage of the transverse abdomen (TAP) promotes excellent analgesia of the abdominal wall and the parietal peritoneum. The meta-analyzes in adults demonstrate improved of postoperative pain and analgesic´s consumption. There are few studies on TAP block in open appendectomies and laparoscopic in pediatrics, they show good results. There is a consensus of the best anesthetic volume for good infiltration of the TAP block, but there are still doubts in the literature about the best concentration of local anesthetics of long duration. The main objective of this prospective, randomly distributed and double-blind clinical trial is to evaluate two concentrations of 0.25% and 0.5% ropivacaine with a volume of 0.4 ml / kg in pain control and the analgesic consumption through 24 hours observation in open Appendectomy in children between 6 and 16 years. 3 groups were being compared: the control group has received no blockade, the other two groups have received TAP blocks if ropivacaine 0,25% and 0,5% 0.4ml/kg. All pacients patients received the same protocols (anesthesia and analgesia). The provided analgesia was dipyrone every 6 hours and ketoprofen every 8 hours, and rescue analgesia was tramadol every 4hours if it were required. The FACE pain scale was used to evaluate the postoperative pain.

+Arms and interventions

ArmTypeInterventionsDescription
control groupNo interventionAll patients had the same protocol of anesthesia and analgesia. The control group didn´t received block.
TAP 0.25 groupExperimentalDrug: RopivacaineThe TAP 0.25 group received TAP block with ropivacaine 0.25% 0.4ml/kg. All patients had the same protocol of anesthesia and analgesia.
TAP 0.5 groupExperimentalDrug: RopivacaineThe TAP 0.5 group received TAP block with ropivacaine 0.5% 0.4ml/kg. All patients had the same protocol of anesthesia and analgesia.
  • Ropivacaine (Drug), also known as Appendectomy: Surgery for appendicitis

+Outcome measures

Primary outcomes

  • Reduce the pain intensity using the Face Pain Scale [24 hour after surgery]: Subjected to the same general anesthesia protocol and postoperative analgesia. The TAP0.25 and TAP0.5 groups received TAP block with ropivacaine 0.25% or 0.5% 0.4ml/kg, the control group didn´t receive block. The evaluation times were: 1 hour, 4 hours, 8 hours, 12 hours, 18 hours and 24 hours after surgery. The time elapsed was recorded, from the end of the surgery to the first use of tramadol. The parents and the patients themselves were instructed to request analgesic at any time.

Secondary outcomes

  • Reduce the opioid consumption through 24 hours postoperative observation [24 hour after surgery]: Subjected to the same general anesthesia protocol and analgesia. The TAP0.25 and TAP0.5 groups received TAP block with ropivacaine 0.25% or 0.5% 0.4ml/kg, the control group didn´t receive block. All patients received dipyrone and ketoprofen, the rescue analgesic used was tramadol 1.5mg / kg (maximum dose of 100mg) up to 4 / 4h when Face´s Scales reached 5 points.

+Eligibility

Sex: All, ages: 6 Years to 16 Years, accepts healthy volunteers

Inclusion Criteria:

* Children between 6 and 16 years who were previously healthy submitted to appendectomy.

Exclusion Criteria:

* Children cardiac, pulmonary, renal and neurological diseases and allergy and refusal of parents, caregivers and patients to participate in the study.

+Locations (1)

FacilityCityCountryStatus
Hospital Infantil Albert SabinFortaleza, CearáBrazil

+Publications

  • Abu Elyazed MM, Mostafa SF, Abdullah MA, Eid GM. The effect of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and neuroendocrine stress response in pediatric patients undergoing elective open inguinal hernia repair. Paediatr Anaesth. 2016 Dec;26(12):1165-1171. doi: 10.1111/pan.12999. Epub 2016 Oct 12. PMID 27731956
  • Carney J, Finnerty O, Rauf J, Curley G, McDonnell JG, Laffey JG. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial. Anesth Analg. 2010 Oct;111(4):998-1003. doi: 10.1213/ANE.0b013e3181ee7bba. Epub 2010 Aug 27. PMID 20802056
  • Lapmahapaisan S, Tantemsapya N, Aroonpruksakul N, Maisat W, Suraseranivongse S. Efficacy of surgical transversus abdominis plane block for postoperative pain relief following abdominal surgery in pediatric patients. Paediatr Anaesth. 2015 Jun;25(6):614-20. doi: 10.1111/pan.12607. Epub 2015 Jan 9. PMID 25571981
  • Reinoso-Barbero F, Poblacion G, Builes LM, Castro LE, Lahoz AI. Successful ultrasound guidance for transversus abdominis plane blocks improves postoperative analgesia after open appendicectomy in children. Eur J Anaesthesiol. 2012 Aug;29(8):402-4. doi: 10.1097/EJA.0b013e328353570e. No abstract available. PMID 22488336