Transversus Abdominis Plane Block for Laparoscopic Appendicectomy in Children

Study Overview
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Brief Summary
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The transversus abdominis plane (TAP) block is a regional anesthetic technique for post operative pain control after abdominal surgical procedures. Its effectiveness in children undergoing laparoscopic appendectomy has not been demonstrated. The investigators evaluate its analgesic efficacy over the first 24 post operative hours.

Official Title
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Transversus Abdominis Plane (TAP) Block for Laparoscopic Appendicectomy in Children: Opioid Saving and Alternative in the Curarization

Conditions
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Laparoscopic Appendectomy

Intervention / Treatment
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* Other: TAP block with Ropivacaine
* Drug: Curare


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient hospitalized in surgery and infantile anesthesia unit or admitted in emergencies for an laparoscopic appendectomy surgery. Patient whose general state corresponds to the classification of the American Society of Anesthesiologists (ASA) I to II Patient member in a national insurance scheme Exclusion Criteria: Patient with drilled appendicitis or peritonitis Patient with a contraindication to local anesthesics Patient with a contraindication to TAP block Patient with allergies or known hypersensitivity to curare

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group 1<br>Curare: Atracurium injection at 0.5 mg/kg | Drug: Curare<br>* Atracurium injection at 0.5 mg/kg at least 3 minutes before the surgical incision<br>* Other names: Succinylcholine;|
| Experimental: Group 2<br>TAP block and curare: Ultrasound-guided transversus abdominis plane block wih Ropivacaine injection 0.2% at 0.3 ml/kg then atracurium injection at 0.5 mg/kg | Other: TAP block with Ropivacaine<br>* Ultrasound-guided transversus abdominis plane block wih Ropivacaine injection 0.2% at 0.3 ml/kg<br>* Other names: Transversus abdominis plane (TAP) block with ropivacaine;Drug: Curare<br>* Atracurium injection at 0.5 mg/kg at least 3 minutes before the surgical incision<br>* Other names: Succinylcholine;|
| Experimental: Group 3<br>TAP block: Ultrasound-guided transversus abdominis plane block wih Ropivacaine injection 0.2% at 0.3 ml/kg | Other: TAP block with Ropivacaine<br>* Ultrasound-guided transversus abdominis plane block wih Ropivacaine injection 0.2% at 0.3 ml/kg<br>* Other names: Transversus abdominis plane (TAP) block with ropivacaine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Painkiller of help consumption | Quantity of analgesic of help (Nalbuphine, Nubain®, Dupont Pharma, Paris, France) taken after the surgery. | up to 24 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity after surgery | The post-operative pain will be estimated from the arrival in recovery room with the Face Legs Activity Cry Consolability (FLACC) scale. | up to 24 hours | 
| First demand of analgesic of help | First demand of analgesic of help (Nubain ®) after the surgery | up to 12 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Appendectomy, Laparoscopy, pediatric surgery