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ABSTRACT
The use of transversus abdominis plane block with different local anesthetics is considered as a part of multimodal analgesia regimen in lower abdominal surgeries. How ever no studies have been published comparing bupivacaine and levobupivacaine for transversus abdominis plane block in a pediatric age group. We aimed to compare bupivacaine and levobupivacaine in ultrasound-guided transversus abdominis plane block in patients undergoing lower abdominal surgeries. Its a Randomised double-blind control study with 50 patients with ASA physical status I - II having patients of either sex, of age between 2-10 years with normal liver and renal functions, scheduled for lower abdominal surgery.25 patients in each group. e.g. group B and Group L On comparing the FLACC between the two group, no significant differences were found at 0 min (p=0.631), 1 hr (p=0.937), 2 hr (p=0.317), 4 hr (p=0.317), 6 hr (p=0.371) and 24 hr (0.572). But this difference was found to be significant at 15 min (p=0.016), 30 min (p<0.001), 12 hr (p<0.001) and 18 hr (p=0.028) where the mean FLACC of group B was much more than the group L.The mean time of Post Op analgesia started in group B was 8.44±1.56 hr while in group L the mean Post-op analgesia started was 9.44±1.04 hr. The significant difference in the meantime of Post Op analgesia started was found between the groups (p=0.010). This study concludes that 0.25% Levobupivacaine provided a longer duration of analgesia compared to 0.25% Bupivacaine when used in TAPB for providing postoperative analgesia after lower abdominal surgeries.
KEYWORDS: Transversus Abdominus, Bupivacaine, Levobupivacaine, Post-Operative Analgesia, Lower Abdominal Surgeries
INTRODUCTION
Pain in the pediatric age group for any surgery is much more severe than an adult. As they are unable to express the severity and type of pain so morbidity in this age group is high and this also affects the outcome of surgery so new nerve block studies are needed to overcome these problems. Regional anaesthesia is an essential aspect of modern pediatric anaesthesia which provides superior and long-lasting analgesia without the risk of respiratory depression (1).
The TAP block was first described by McDonnell et al. in 2004, (2) and a ultrasonography (USG)-guided technique was subsequently described by Hebbard et al (3). USG-guided TAP block provides excellent pain relief in...