Surgeon placed transverse abdominis plane (TAP) blocks as an alternative to thoracic epidurals

2022 ◽  
Vol 164 (1) ◽  
pp. 9
Author(s):  
Allison Kay ◽  
Nicole Marjon ◽  
Rosa Guerra ◽  
Edwin Alvarez ◽  
Jocelyn Chapman ◽  
...  
Keyword(s):  
Transverse Abdominis

Contractile properties of expiratory abdominal muscles: effect of elastase-induced emphysema

1987 ◽  
Vol 62 (6) ◽  
pp. 2314-2319 ◽  
Author(s):  
J. S. Arnold ◽  
A. J. Thomas ◽  
S. G. Kelsen
Keyword(s):  
Relaxation Time ◽  
Contractile Function ◽  
Isometric Tension ◽  
Contractile Properties ◽  
Abdominal Muscles ◽  
Force Frequency ◽  
Contraction Time ◽  
Transverse Abdominis ◽  
External Oblique

The present study examined the intrinsic contractile properties and endurance of the transverse abdominis and external oblique abdominal expiratory muscles in adult hamsters and compared their performance with the diaphragm. Experiments were performed in vitro on isolated bundles of muscle stimulated electrically. In control animals peak twitch tension was similar in the two muscles. In contrast, the twitch contraction time and one-half relaxation time of the transverse abdominis were significantly greater than that of the external oblique. The isometric tension generated over a range of stimulus frequencies (i.e., the force-frequency relationship) was a greater percent of the maximum value in response to subtetanizing frequencies (10–40 Hz) in the transverse abdominis than in the external oblique. For both abdominal muscles, however, the tension generated over this range of stimulus frequencies was less than that of the diaphragm. The endurance of the transverse abdominis during repeated contractions was significantly greater than that of the external oblique but similar to the diaphragm. The effect of chronic hyperinflation produced by elastase-induced emphysema on the contractile function of the two muscles was assessed in a second group of adult hamsters. In emphysematous animals peak twitch tension, contraction time, and one-half relaxation time of the twitch and force-frequency curves of muscles from emphysematous animals were similar to values obtained in control animals for both the external oblique and transverse abdominis. However, the endurance of both the transverse abdominis and external oblique muscles was greater in emphysematous than control animals.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Effects of Ropivacaine Combined with Ketorolac Transverse Abdominis Plane Block on Postoperative Analgesia in Patients Undergoing Gynecological Laparoscopic Surgery

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Yidong Hao ◽  
Rui Xia ◽  
Qifei Li ◽  
Xiaoyong Zhao ◽  
Xiangyu Liu
Keyword(s):  
Laparoscopic Surgery ◽  
Gastrointestinal Bleeding ◽  
Postoperative Analgesia ◽  
Adverse Reactions ◽  
Random Number ◽  
Opioid Consumption ◽  
Tap Block ◽  
Total Dosage ◽  
Transverse Abdominis ◽  
Intravenous Ketorolac

Objective — To observe the effects of ropivacaine combined with ketorolac transverse abdominis plane (TAP) block on postoperative analgesia in patients undergoing gynecological laparoscopic surgery. Methods — 90 ASAⅠorⅡpatients, aged 18-65 years and weighting 40-80 kg, scheduled for gynecological laparoscopic surgery were recruited and divided into three groups using random number table:ropivacaine combined with ketorolac 15 mg/side for TAP block (KR group), ropivacaine for TAP block and 30 mg preoperatively intravenous ketorolac (KIVR group) and ropivacaine for TAP block alone (R group) with 30 patients in each group. Intraoperative opioid consumption, Bruggrmann comfort scale (BCS) scores at 2h (T1), 4h (T2), 8h (T3), 12h (T4), 16h (T5), 24h (T6) after surgery were recorded. Adverse reactions such as nausea and vomiting, respiratory depression, local anesthetic poisoning, gastrointestinal bleeding, and complications related to TAP block operation were recorded. Results — The total consumpsion of sufentanil was higher in the R group than that in the KIVR group and KR group (P < 0.05). The total dosage of remifentanil in R group was higher than that in KR group (P < 0.05). The BCS scores of the three groups at T3, T4, T5 and T6 were lower in R group than that in KR group (P < 0.05) while R Group was lower than KIVR group at T3 and T4 (P < 0.05), and KIVR group was lower than KR group at T5 and T6. There was no statistically differences in BCS score between the three groups at T1 and T2 (P > 0.05). No statistical differences in the incidence of adverse reactions among all groups were observed. Conclusion — Ropivacaine combined with ketolorac transverse abdominisplane block reduced the intraoperative opioid consumption, improved postoperative comfort score and do not increased the incidence of adverse reactions in gynecological laparoscopic surgery.

scholarly journals O50 ALTERATIONS IN THE ABDOMINAL WALL MUSCULATURE AFTER ENDOSCOPIC ANTERIOR AND OPEN POSTERIOR COMPONENT SEPARATION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Erling Oma ◽  
Jan Kim Christensen ◽  
Jorge Daes ◽  
Lars Nannestad Jorgensen
Keyword(s):  
Abdominal Wall ◽  
Case Series ◽  
Muscle Thickness ◽  
Component Separation ◽  
Fascial Closure ◽  
Lateral Abdominal Wall ◽  
Transverse Abdominis ◽  
Abdominal Wall Muscle ◽  
Anterior Component Separation

Abstract Aim Effects of component separation (CS) on abdominal wall musculature have only been investigated in smaller case series. The study aimed to compare abdominal wall alterations following endoscopic anterior component separation (EACS) or transverse abdominis release (TAR). Material and Methods Computed tomography scans were evaluated in patients who underwent open ventral hernia repair with TAR or EACS. Lateral abdominal wall muscle thickness and displacement were compared with preoperative images after bilateral CS and the undivided side postoperatively after unilateral CS. Results In total, 105 patients were included. The mean defect width was 12.2 cm. Fifty-five (52%) and 15 (14%) underwent bilateral and unilateral EACS, respectively. Five (5%) and 14 (13%) underwent bilateral and unilateral TAR, respectively. Sixteen (15%) underwent unilateral EACS and contralateral TAR. Complete fascial closure was achieved in 103 (98%) patients. The external oblique and transverse abdominis muscles were significantly laterally displaced with a mean of 2.74 cm (95% CI 2.29-3.19 cm) and 0.82 cm (0.07-1.57 cm) after EACS and TAR, respectively. The combined thickness of the lateral muscles was significantly decreased after EACS (mean decrease 10.5% [5.8-15.6%]) and insignificantly decreased after TAR (mean decrease 2.6% [-4.8-9.5%]), mean reduction difference EACS versus TAR 0.22 cm (-0.01-0.46 cm). One (1%) patient developed an iatrogenic linea semilunaris hernia after EACS. The recurrence rate was 19% after mean 1.7 years follow-up. Conclusions The divided muscle was significantly more laterally displaced after EACS compared with TAR. The thickness of the lateral muscles was slightly decreased after EACS and unchanged after TAR.

scholarly journals Intra-rater reliability of transversus abdominis measurement by a novice examiner: Comparison of “freehand” to “probe force device” method of real-time ultrasound imaging

Ultrasound ◽  
2019 ◽  
Vol 27 (3) ◽  
pp. 156-166 ◽  
Author(s):  
Vanessa L Kennedy ◽  
Carol A Flavell ◽  
Kenji Doma
Keyword(s):  
Measurement Error ◽  
Real Time ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Coefficient Of Variation ◽  
Repeated Measures ◽  
Intraclass Correlation ◽  
Transversus Abdominis ◽  
Rater Reliability ◽  
Transverse Abdominis

A “free hand” real-time-ultrasound method is commonly applied to measure transversus abdominis. Potentially, this increases transversus abdominis measurement error due to uncontrolled variability in probe to skin force, inclination, and roll, particularly for novice examiners. This single-group repeated-measures reliability study compared the intra-rater reliability of transversus abdominis thickness and activation measurement by a novice examiner between free hand and a standardized probe force device method. The examiner captured ultrasound videos of transversus abdominis in a single session in healthy participants ( n =  33). Free hand ultrasound featured uncontrolled probe force, inclination, and roll, while probe force device method ultrasound standardized these parameters. Images of transversus abdominis at rest and contracted were measured and transversus abdominis activation calculated. Intraclass correlation coefficient, coefficient of variation, standard error of measurement, and worthwhile differences were calculated. The probe force device method resulted in greater reliability (intraclass correlation coefficient = 0.75–0.96) and lower measurement error (coefficient of variation = 8.89–28.7%) compared to free hand (intraclass correlation coefficient = 0.63–0.93; coefficient of variation = 6.52–29.4%). Reliability was good for all measurements except free hand TrA-C, which was moderate. TrA-C had the lowest reliability, followed by contracted thickness of the transverse abdominis, with resting thickness of the transverse abdominis being highest. Worthwhile differences were lower using a probe force device method versus free hand for resting thickness of the transverse abdominis and contracted thickness of the transverse abdominis and similar for TrA-C. Standardization using probe force device method ultrasound to measure transversus abdominis improved intra-rater reliability in a novice examiner. Use of a probe force device method is recommended to improve reliability through reduced sources of measurement error. Probe force device method intra- and inter-rater reliability in examiners of varying experience, in clinical populations, and to visualize other structures merits exploration.

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