The efficacy of transversalis fascia plane block in pediatric inguinal herniotomy: a randomized controlled study.

Abstract

Objective: The post-operative analgesic efficacy of transversalis fascia plane (TFP) block is controversial in pediatric patients undergoing herniotomy. This study aims to compare the efficacy of TFP block and standard analgesic methods.

Methods: Sixty patients aged 1-8 years who underwent the open procedure of herniotomy were randomly divided into two groups TFP block (n = 30) or control group (n = 30). The TFP group received 0.25% bupivacaine at 0.5 mL/kg. Routine analgesia protocol was applied to Group C. Pain scores (FLACC), family satisfaction, block complications, nausea, sedation score, and additional analgesic requirements were recorded.

Results: FLACC pain scores at post-anesthesia care unit (PACU), 1st, 2nd, and 4th h were statistically significantly lower in Group TFP compared to group control (p < 0.05). Three patients in Group TFP and 12 in group control required rescue analgesics at PACU (p = 0.015). Ibuprofen was required in two patients in Group TFP and 11 in Group Control (p = 0.010). Parental satisfaction is higher in the TFP group than in Group Control (p < 0.001). There was no statistically significant difference between the groups in terms of post-operative nausea and sedation scores (p > 0.05).

Conclusion: We conclude that TFP block in pediatric patients is an appropriate approach as a part of multimodal analgesia. It creates fewer pain scores in the early post-operative period, requires less additional analgesia, and increases family satisfaction.