Rectus sheath block for postoperative pain relief in children undergoing major abdominal surgery

Abstract

Background: Regional anaesthetic techniques in children has become increasingly popular and used to provide analgesia for umbilical and epigastric hernia repair, laparoscopic surgery, pyloromyotomy and other small midline incisions. Our objective was to assess the efficacy and side effects of the rectus sheath block than a control group that received intravenous tramadol, for pain control after major abdominal surgery in children. Methods: Sixty children aged 1-15 years who underwent laparotomy via transverse incision were recruited for this randomised study. Patients were allocated randomly into two groups: group R (n: 30) patients who had rectus sheath block with levobupivacaine 0.25% and group T (n: 30), control patients who received iv tramadol with local saline injections into rectus sheath. CHEOPS and sedation scores were noted after the injection of local anesthetic at 5, 15, 30, 60 minutes and 2, 6, 12, 24 hours. Results: The mean total amounts of tramadol used by the levobupivacaine and the normal saline groups in the first 24 h were 0.95 mg/kg and 4.07 mg/kg. There was no significant difference between the groups in CHEOPS pain score and sedation score. The incidence of were lower in group R than in Group T. Conclusions: In terms of postoperative nausea and vomiting and analgesic consumption and the duration of analgesia the rectus sheath block has superiority to intravenous tramadol in children undergoing major abdominal surgery.