Dual Transversus Abdominis Plane Block in Pediatric Renal Transplant: Effect on Pain Control

Study Overview
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Brief Summary
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Alleviating pain in children undergoing renal transplant is extremely challenging. Large incisions as those of renal transplant (Gibson's incision) require special techniques of pain control that don't affect hemodynamics or renal function. Since the transplant incision doesn't cross midline; a dual-TAP block is thought to be effective in providing pain control in such procedure as it will anesthetize the dermatomes T6-T12, the muscles of the anterior abdominal wall together with the underlying parietal peritoneum.

Official Title
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Unilateral Dual Transversus Abdominis Plane Block in Pediatric Renal Transplant: A Randomized Control Study

Conditions
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Renal Failure

Intervention / Treatment
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* Drug: bupivacaine
* Drug: Pethidine
* Drug: perfalgan
* Drug: fentanyl


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 3-16 years end stage renal disease no known allergy to bupivacaine both sexes Exclusion Criteria: known allergy to bupivacaine

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 16 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: dual TAB group<br>22 patients will receive unilateral dual transversus abdominis plane (TAB) block USING bupivacaine 0.25% at a dose of 2 mg/kg | Drug: bupivacaine<br>* bupivacaine 0.25% at a dose 2 mg/kg in the transversus abdominis plane<br>Drug: Pethidine<br>* pethidine intravenous at a dose 1mg/kg when pain score more than 5 postoperative rescue analgesia<br>Drug: perfalgan<br>* intravenous paracetamol<br>Drug: fentanyl<br> <br> |
| Sham Comparator: control group<br>22 patients who will not receive dual TAB block | Drug: Pethidine<br>* pethidine intravenous at a dose 1mg/kg when pain score more than 5 postoperative rescue analgesia<br>Drug: perfalgan<br>* intravenous paracetamol<br>Drug: fentanyl<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total dose of rescue analgesia | pethidine given as rescue analgesia postoperative. | from the time of transfer of the patient to the intensive care unit at one hour intervals for 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain scoring system (objective behavioural pain score) |  | from the time of transfer to the nephrology ICU, every hour for the first 24 hours postoperative | 
| Intraoperative blood pressure | measure systolic and diastolic blood pressure | from the induction of anesthesia till end of surgery at half an hour intervals average duration is 4 hours | 
| postoperative blood pressure | record systolic and diastolic blood pressure every hour for the first 24 hours postoperative | from the time of transfer of the patient to the intensive care unit at one hour intervals for 24 hours | 
| postoperative heart rate |  | from the time of transfer of the patient to the intensive care unit at one hour intervals for 24 hours | 
| intraoperative heart rate |  | from the induction of anesthesia till end of surgery at half an hour intervals average duration is 4 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pediatric, renal transplant, pain, dual TAB