Trial reportSurgical endoscopy2026
Transversus abdominis plane block improved surgical conditions in neuromuscular blocker-free pediatric laparoscopic hernia repair: a randomized trial.
Trial report in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPediatric laparoscopic hernia repair (LHR) is a short, commonly performed ambulatory procedure that can be conducted under general anesthesia without neuromuscular blocker (NMB). This prospective randomized controlled trial evaluated whether a transversus abdominis plane (TAP) block facilitates the implementation of NMB-free anesthesia in this surgical setting.
methodsEighty pediatric patients scheduled for LHR without NMB were stratified by age (≤ 3 or > 3 years) and randomized to receive either a bilateral TAP block after induction (TAPB group) or surgical-site local infiltration at closure (Control group). The primary outcome was the mean intraoperative Leiden Surgical Rating Scale (L-SRS) score.
resultsThe TAPB group demonstrated significantly higher mean L-SRS scores compared with controls (mean difference, 0.9; 95% CI, 0.69-1.11; p < 0.001), consistent across age subgroups. Age-stratified analysis revealed a markedly increased risk of intraoperative hemodynamic stress responses in the Control group, with adjusted odds ratios of 10.09 (95% CI, 3.46-29.42; Cochran's p < 0.001) for mean arterial pressure elevation ≥ 15% and 4.78 for heart rate elevation ≥ 15%, as well as a higher need for remifentanil rescue (adjusted odds ratio, 10.09; 95% CI, 3.44-29.60; Cochran's p < 0.001). The TAPB group also exhibited improved postoperative recovery, with significantly lower rates of emergence delirium (10 vs. 37.5%), moderate-to-severe pain (37.5 vs. 80%), and postoperative fentanyl rescue (2.5 vs. 20%; all p < 0.05).
conclusionThe addition of a TAP block significantly improved surgical conditions during pediatric LHR under an NMB-free general anesthesia strategy, while attenuating stress responses and enhancing postoperative recovery quality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.