Tranversus Abdominis Plane Block vs. Local Wound Infiltration for Elective Laparoscopic Cholcystectomy in Children and Adolescents: A Prospective Randomized-Controlled Trial
Nicole Horn, MD
Primary Investigator
Brian Gray, MD
Primary Investigator
Brief description of study
This study investigates pain control methods for children and adolescents undergoing elective laparoscopic cholecystectomy, which is a surgery to remove the gallbladder. The study will compare two methods: the transversus abdominis plane (TAP) block and local wound infiltration (LWI). Both methods utilize the same numbing medication. A TAP block involves injections given near specific nerves to block sensations of pain from a targeted area of the body, specifically helping to lessen feelings of pain around the belly. Local wound infiltration involves injecting anesthetic directly into the incision site, similar to how a dentist may numb your gums.
Participants will be randomly assigned to receive either a TAP block or local wound infiltration during their surgery. The study will measure and compare the effectiveness of these two methods in managing postoperative pain. Additionally, it will examine differences in the amount of pain medication requested post-surgery, the duration of hospital stay, pain scores in the recovery area, and the timing of initial pain medication requirement during the postoperative period. By doing so, the study aims to understand which method provides better pain relief for young patients undergoing this type of surgery.
Detailed description of study
- Who can participate: Children and adolescents aged 8 to 18 years who are scheduled to undergo elective laparoscopic cholecystectomy can participate in this study.
- Study details: Participants will be divided into two arms: one receiving a TAP block and the other receiving local wound infiltration during surgery. The study will observe and compare pain levels after surgery in both groups.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: laparoscopic cholecystectomy
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Age: 8 years - 17 years
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Gender: All
Inclusion criteria
- 8-17 yrs of age at date of enrollment.
Elective laparoscopic or da Vinci cholecystectomy scheduled for any diagnostic reason.
Exclusion criteria
- Chronic pain or chronic use of narcotic or other prescription pain medications.
- Use of pain medication within 24 hours before surgery
- Prior major abdominal surgery
- Evidence of acute inflammation
- Patients with acute cholecystitis
- Bleeding / coagulation disorder
- Seizure disorder
- Renal dysfunction
- Infection at injection sites for TAP block or trocar placement
- Contraindication to LWI or TAP block procedure, as determined by surgeon or anesthesiologist performing the procedure (including, but not limited to, previous incision distorting anatomy or inability to visualize anatomical planes)
- Any known allergy to medications used in this study
- Patient unable to verbalize pain score or independently assess pain level
- Unstable patient in need of emergent intervention at surgeon discretion
- Patients who are known to be pregnant
- Patients who are currently prisoners
- Children in custody of the state
- Subjects will a BMI >/= 50
- Investigator discretion for any other reason
