The aim of this prospective randomized controlled trial is to compare the postoperative analgesic efficacy of ultrasound-guided transversus abdominis plane (TAP) block and umbilical paramedian linea semilunaris block in pediatric patients undergoing elective laparoscopic abdominal surgery.
A total of 56 pediatric patients will be randomly assigned in a 1:1 ratio to receive either a TAP block or a linea semilunaris block after induction of general anesthesia and before the start of surgery. Both blocks will be performed under ultrasound guidance using 0.2% bupivacaine at a volume of 0.5 mL/kg, with the total dose limited to 2 mg/kg.
The primary outcome will be total opioid consumption during the first 24 hours after surgery. Secondary outcomes will include postoperative pain scores, time to first analgesic requirement, additional analgesic requirements, postoperative nausea and vomiting, and block-related complications.
Patients scheduled for elective pediatric laparoscopic abdominal surgery
Age within the specified eligibility range
American Society of Anesthesiologists (ASA) physical status I or II
Written informed consent provided by a parent or legal guardian
Refusal of the parent or legal guardian to participate
Emergency surgery
Inadequate ultrasound visualization
Coagulopathy
Parallel
Ultrasound-Guided Transversus Abdominis Plane Block
Procedure/SurgeryFollowing induction of general anesthesia and before the start of surgery, an ultrasound-guided transversus abdominis plane (TAP) block will be performed. After identification of the target fascial plane and confirmation by hydrodissection, 0.2% bupivacaine will be administered at a volume of 0.5 mL/kg. The total bupivacaine dose will be limited to 2 mg/kg.
Ultrasound-Guided Linea Semilunaris Block
Procedure/SurgeryFollowing induction of general anesthesia and before the start of surgery, an ultrasound-guided umbilical paramedian linea semilunaris block will be performed. The linea semilunaris will be identified under ultrasound guidance, and the appropriate fascial plane will be confirmed by hydrodissection. Subsequently, 0.2% bupivacaine will be administered at a volume of 0.5 mL/kg. The total bupivacaine dose will be limited to 2 mg/kg.
Total Postoperative Opioid Consumption During the First 24 Hours
Total opioid consumption administered for postoperative analgesia will be recorded during the first 24 hours after surgery.
Postoperative Pain Scores
Postoperative pain intensity will be assessed using age-appropriate pain assessment scales (FLACC or Wong-Baker Faces Pain Rating Scale).
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Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital
Lead sponsor
Dicle University
Sponsor institution
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