title: [Ultrasound-guided Rectus Sheath Block vs Transversus Abdominis Plane Block in Children Undergoing Umbilical Hernia Repair].
abstract: BACKGROUND
  Although many reports describe the usefulness of the rectus sheath block (RSB) in the umbilical hernia repair, the efficacy of the transversus abdominis plane block (TAPB) is rarely reported. The purpose of this study was to compare the efficacy and technique of ultrasound-guided RSB and TAPB in children undergoing umbilical hernia repair.
  
  
  METHODS
  Thirty-four children younger than 12 years of age scheduled for umbilical hernia repair were enrolled in this prospective observer-blinded randomized clinical trial. They were randomly assigned either to RSB group (median age, 3.7 years) or TAPB group (median age, 3.8 years). After the induction of general anesthesia with sevoflurane, nitrous oxide, and oxygen children in both groups received regional anesthesia with 0.3 ml x kg(-1) of 0.25% ropivacaine on each side under ultrasound guidance. Hemodynamic changes at the skin incision, postoperative pain scores and parental satisfaction were recorded. Anesthesiologists rated the quality of ultrasound images and easiness of the block performance.
  
  
  RESULTS
  The patients' demographics of the two groups were similar. There were no significant differences in the time needed for the block procedure, quality of ultrasound images and the change of the heart rate and blood pressure at the skin incision between the two groups. Postoperative pain score (immediately, 2 and 4 hours after the operation), need for rescue analgesia and satisfaction of the parents also did not differ. There were no major complications in the patients.
  
  
  CONCLUSIONS
  TAPB provided comparable perioperative analgesia and easiness of block performance to RSB in the pediatric umbilical hernia repair.
authors.forename: Naoko
authors.initials: N
authors.lastname: Torii
authors.forename: Kazuya
authors.initials: K
authors.lastname: Tachibana
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Muneyuki
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Kinouchi
mesh_terms: D000577:Amides / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006554:Hernia, Umbilical / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D009407:Nerve Block / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D000077212:Ropivacaine; D014463:Ultrasonography
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine