scholarly journals A Comparison of effect of preemptive versus postoperative use of ultrasound-guided bilateral transversus abdominis plane (TAP) block on pain relief after laparoscopic cholecystectomy

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Poupak Rahimzadeh ◽  
Seyed Hamid Reza Faiz ◽  
Kaveh Latifi-Naibin ◽  
Mahzad Alimian
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Significant Difference

AbstractNowadays, there are various methods to manage pain after laparoscopic cholecystectomy. The aim of this study was to compare the effectof preemptive versus postoperative use of ultrasound-guided transversus abdominis plane (USG-TAP) block on pain relief after laparoscopic cholecystectomy. In this single-blinded randomized clinical trial, the patients who were candidates for laparoscopic cholecystectomy were randomly divided into the two groups (n = 38 per group). In the preemptive group (PG) after the induction of anesthesia and in the postoperative group (POG) after the end of surgery and before the extubation, bilateral ultrasound-guided transversus abdominis plane (TAP) block was performed on patients using 20 cc of ropivacaine 0.25%. Both groups received patient controlled IV analgesia (PCIA) containing Acetaminophen (20 mg/ml) plus ketorolac (0.6 mg/ml) as a standard postoperative analgesia and meperidine 20 mg q 4 h PRN for rescue analgesia. Using the numerical rating scales (NSR), the patients’ pain intensity was assessed at time of arrival to the PACU and in 2th, 4th, 8th, 12th, 24th h. Primary outcome of interest is NSR at rest and coughing in the PACU and in 2th, 4th, 8th, 12th, 24th h. Secondary outcomes of interests were the time to first post-surgical rescue analgesic and level of patients’ pain control satisfaction in the first 24 h. The USG-TAP block significantly decreased pain score in the POG compared to the PG, and also the pain was relieved at rest especially in 8 and 12 h (p value ≤ 0.05) after the surgery. Pain score after coughing during recovery at 2, 8 and 12 h after the operation were significantly decreased. (p value ≤ 0.05) The patient satisfaction scores in the POG were significantly higher in all times. There was a statistically significant difference between the two groups in terms of rate of postoperative nausea and vomiting (PONV), indicating that patients in the POG had significantly lower incidences of the PONV compared tothe PG. The time to first analgesic request was significantly shorterin the POG, which was statistically significant (p value = 0.089). There was no statistically significant difference between the two groups in terms of consumption of analgesics. The postoperative TAP block could offer better postoperative analgesia than preepmtive TAP block.

scholarly journals Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

2019 ◽  
Vol 4 (2) ◽  
pp. 755-758
Author(s):  
Roshan Pradhan ◽  
Seema Kumari Mishra ◽  
Lalit Kumar Rajbanshi ◽  
Kanak Khanal ◽  
Batsalya Arjyal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia ◽  
Visual Analogue Pain ◽  
Significant Difference

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption. Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section. Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively. Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points.  Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

scholarly journals A prospective study of efficacy of ultrasound guided transversus abdominis plane block for postcesarean analgesia

2019 ◽  
Vol 8 (5) ◽  
pp. 1951
Author(s):  
Sravani Manam ◽  
R. N. V. Swetha ◽  
A. S. Kameswara Rao ◽  
S. G. K. Murthy
Keyword(s):  
Total Dose ◽  
Postoperative Period ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Group B

Background: The ultrasound guided transversus abdominis plane (TAP) block which provides effective analgesia after lower abdominal surgeries including caesarean section. It is a simple and reliable technique. In this prospective, randomized double-blind study, we determined the efficacy of TAP block using 0.25% Bupivacaine and 0.9N Saline with respect to VAS for pain, postoperative Tramadol consumption and post-operative ondansetron usage.Methods: This study was conducted on 100 adult patients of ASA physical status I and II in the   age group of 18 to 40 years undergoing elective lower segment cesarean section under spinal anaesthesia. Study group received TAP block with 0.25% Bupivacaine and control group received 10 ml of 0.9N saline on each side. Patients were analyzed for postoperative pain by pain score (at rest, on movement, on cough) using VAS was recorded at 0, ½, 1, 2, 4, 6, 12 and 24 hours postoperatively. Need for rescue analgesia was assessed by time to first dose of Tramadol requirement and total dose of Tramadol over 24 hours of postoperative period. Ondansetron (4 mg i.v.) was administered whenever nausea score was more than 2 or the patient vomited. All the data was noted using uniform performs.Results: Patients received TAP block with 0.25% Bupivacaine had better pain scores at first hour of postoperative period during rest, cough and movement which was statistically significant (p<0.0010) in comparison to group B. There was a statistically significant difference (p <0.001) in the requirement of total dose of Tramadol as a rescue analgesia in patients who received transversus abdominis block with 0.25% Bupivacaine (138.77 mg) in comparison with other group(240 mg).The mean time to first request for Tramadol was significantly longer in group A (5.8 hrs)  in comparison to group B (1.93 hrs) with p value <0.001. Patients received TAP block with 0.9N saline needed more dose of Ondansetron, however, the difference was not statistically significant (p >0.001).Conclusions: TAP block using ultrasound provides substantial reduction in Tramadol consumption, time to first dose of rescue tramadol when compared with control group. This study reinforces the recommendation for TAP as a part of multimodal post-operative analgesic regimen.

scholarly journals Comparison of Ultrasound-Guided Subcostal Transversus Abdominis Plane Block and Quadratus Lumborum Block in Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Clinical Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Çağdaş Baytar ◽  
Canan Yılmaz ◽  
Derya Karasu ◽  
Serra Topal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Pain Scores ◽  
Quadratus Lumborum ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Analgesia Requirement

Background. The aim of this study was to compare the effectiveness of ultrasound-guided (USG) subcostal transversus abdominis plane (TAP) block and quadratus lumborum (QL) block as preventive analgesia methods after laparoscopic cholecystectomy. Methods. A total of 120 patients, 18–75 years of age, were separated into 2 groups preoperatively. Patients in group TAP (n = 60) received 0.3 ml/kg bupivacaine with USG bilateral subcostal TAP block; patients in group QL (n = 60) received 0.3 ml/kg bupivacaine with USG bilateral QL block. Patients were assessed 24 h postoperatively, and pain scores, time to first analgesia requirement, total analgesia dose, and postoperative complications during the first 24 h were recorded. Results. Fifty-three patients in group TAP and 54 in group QL were ultimately evaluated. No statistically significant difference was found in at rest and dynamic visual analog scale scores between the groups. There was also no statistically significant difference between the groups with regard to total analgesia consumption. Although the duration of anesthesia was significantly longer in group QL, no statistically significant difference was found in the duration of surgery between the groups (p<0.05). Conclusions. Results of this study demonstrated that USG subcostal TAP and QL blocks similarly reduced postoperative pain scores and analgesia consumption, with high patient satisfaction. However, subcostal TAP block could be considered preferable to QL block because it can be applied easily and in a shorter time.

scholarly journals Intraperitoneal Versus Ultrasound Guided Transversus Abdominis Plane Block by Bupivacaine-Magnesium Sulphate for Pain Relieafter Laparoscopic Cholecystectomy

2020 ◽  
pp. 81-90
Author(s):  
Nashwa I. Hamoda ◽  
Hesham I. El Tatawy ◽  
Nagat S. El Shmaa ◽  
Mohammad I. Okab
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Analgesic Consumption ◽  
Group I ◽  
Group Ii

Background and Aim: Intraperitoneal (IP) administration of local anesthetic is considered a method of control of visceral component of pain. This method cannot be used as sole agent for pain relief after laparoscopic cholecystectomy (LC). Transversus Abdominis Plane block (TAP) becomes a useful anesthetic technique in the treatment of postoperative pain after the LC surgery. The aim of the study was to compare between IP bupivacaine –Magnesiu;m Sulfate (MgSO4) and TAP by bupivacaine- MgSO4 for pain relief after LC. Materials and Methods: This was a randomized double blinded study on sixty patients ASA I &II, age from 18 to 60 years old, undergoing elective LC surgery were randomly classified into two equal groups (30 patients in each group). Group I: IP instillation of 30 ml [15 ml bupivacaine 0.5% (75mg) plus 2.5ml MgSO4 (250 mg) plus 12.5 normal saline].Group II: Ultrasound guided subcostal TAP block was performed by using total volume 20 ml on each side [10 ml bupivacaine %0.5 (50 mg) plus 1.5ml MgSO4 (150 mg) plus 8.5 normal saline]. Heart rate (HR) and Mean Arterial Blood Pressure (MAP) were measured at 5 min before induction and every 15min after induction till the end of operation and then every 5 min for the first 20 mins after administration of study drugs then they recorded at interval of 30mins, 1hr, 2hrs, 4hr and 6hr postoperative. Numeric Rating Scale (NRS) at emergence, 2, 4, 8, 12, 18 and 24hr after recovery, first rescue analgesia time, postoperative analgesic consumption, length of hospital stay(LOS), patients’ satisfaction and post-operative complications were recorded. Results: There were insignificant differences in HR and MAP between the two groups. There was a significant decrease in NRS at 4hr and 8 hr in group II than group I. There was a significant decrease regarding to time of first rescue analgesia, total postoperative analgesic consumption and LOS in group II compared to group I. There was a significant increase of satisfaction in group II compared to group I. There was an insignificant difference between both groups in nausea, vomiting, hypotension, bradycardia, bradypnea or MgSO4 toxicity. Conclusion: TAP by bupivacaine-MgSO4 has superior analgesia, longer duration, less postoperative analgesic consumption and more satisfaction in patients undergoing LC than IP block by bupivacaine-MgSO4.

Evaluation of the Postoperative Analgesic Effect of 2 Different Blocks after Pediatric Circumcision Surgery

2021 ◽  
pp. 1-6
Author(s):  
Mehmet Mutlu ◽  
Seray Turkmen
Keyword(s):  
Observational Study ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Prospective Observational Study ◽  
Transversus Abdominis ◽  
Block Group ◽  
Tap Block ◽  
Analgesic Requirement ◽  
Rescue Analgesia ◽  
Significant Difference

<b><i>Background:</i></b> Circumcision is a painful day-case surgery. Regional anesthesia techniques are used effectively for anesthesia and postoperative analgesia after pediatric circumcision surgery. <b><i>Objective:</i></b> Our prospective observational study aimed to compare postoperative analgesic efficiency of a dorsal penile nerve (DPN) block with a transversus abdominis plane (TAP) block after male pediatric circumcision surgery and complications related to each block. <b><i>Study Design:</i></b> We enrolled 80 male children under the age of 10 years with American Society of Anesthesiologists I–II status scheduled for circumcision in this prospective observational study. A TAP or DPN block was performed after induction of general anesthesia before surgery with ultrasound (US) guidance. Postoperative pain was assessed with Faces Pain Scale-Revised and the Faces, Legs, Activity, Cry and Consolability scale. <b><i>Results:</i></b> There was no statistically significant difference between the groups regarding 30-min pain score levels (<i>p</i> &#x3e; 0.05). But, the 1st hour, 2nd hour, 6th hour, 12th hour, and 24th-hour pain score levels in the TAP block group were statistically significantly higher than those of the DPN block group (<i>p</i> &#x3c; 0.05). The 1st rescue analgesic requirement in the TAP block group was at the 6th hour postoperative. There was no need for rescue analgesia in the DPN block group during the postoperative 24-h follow-up. <b><i>Discussion:</i></b> A US-guided DPN block provided effective and long-lasting postoperative analgesia for circumcision surgery with statistically significantly lower pain score levels than a US-guided TAP block. <b><i>Conclusion:</i></b> This study found that a TAP block alone was insufficient to provide adequate postoperative analgesia for circumcision surgery compared to DPN block.

Comparison between Ultrasound Guided Transversus Abdominis Plane Block versus Ultrasound Guided IlioInguinal/Iliohypogastric Nerves Block for Postoperative Analgesia in Patients Undergoing Unilateral Oblique Inguinal Hernia Repair Under General Anesthesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Shrouk Ayman Mohamed Soliman Faramawy ◽  
Samia Abdel-Mohsen Abdel-Latif ◽  
Mohamed Abdel-Salam Menshawe Abdel-Atte ◽  
Ibrahim Mohammed El Sayed Ahmed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
General Anesthesia ◽  
Inguinal Hernia Repair ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Pain Scores

Abstract Background Inguinal hernia considered the third common disease in surgeries for adults after acute appendicitis and proctologic disorders. About 20 millions of inguinal hernia repairs are performed globally. Inguinal herniorrhaphy is frequently associated with persistent postoperative pain. Objectives The aim of this study is to assess the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared to ilioinguinal/iliohypogastric nerves block after unilateral inguinal hernia repair regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received. Patients and Methods The study was conducted on 70 randomly chosen patients aged 21 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia, in Ain Shams University Hospitals after approval of the medical ethical committee. Results The results of the study revealed that there is Patients receiving TAP block had significantly lower pain scores at 4 h and 6 h after operation, delay time for rescue analgesia and decrease total need of analgesic in first 24 h post operative compared with patients who received ilioinguinal/ iliohypogastric nerves block. Conclusion TAP block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to ilioinguinal/iliohypogastric nerves block. This technique can be a promising mode of postoperative analgesia when epidural catheter insertion is contraindicated.

scholarly journals Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

2021 ◽  
Vol 15 (1) ◽  
pp. 22-29
Author(s):  
Tamer N. Abdelrahman ◽  
Rasha G. Abu-Sinna
Keyword(s):  
Magnesium Sulphate ◽  
Transversus Abdominis ◽  
Anesthetic Technique ◽  
Control Group ◽  
Time Interval ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Group D

Introduction: The TAP block is a regional anesthetic technique, which blocks neural afferents between T6 and L1, which provide anterior abdominal walls and therefore help to alleviate postoperative pain. Aim: The aim is to compare the efficacy of preoperative single low dose of intravenous MgSO4 versus intravenous dexamethasone as adjuvants to ultrasound guided TAP block for prolongation of postcesaren analgesia. Materials and Methods: A total 60 pregnant females were selected undergoing elective caesarean sections under general anesthesia with ultrasound-guided transversus abdominis plane (TAP) block done at the end of surgery. Patients were randomly and equally allocated into three groups of 20 patients each. The first group of patients were classified as magnesium sulphate group (M)who received 50 mg/Kg IV, the second group of patients were classified as dexamethasone group (D) who received 2 mg IV and the third group was classified as the placebo group (C) who received IV saline. Results: Comparison of the VAS at 6 and 12 hours postoperatively showed statistically significantly lower values in group (M) and group (D) compared to group (C) and also group (M) was significantly lower than group (D) as well. The time interval until first rescue analgesia (Nalbuphine) needed by the patients (VAS ≥ 50) was significantly longer in group (M) compared to group (D) and group (C) consecutively. Additionally, it was significantly longer in group (D) than in the control group(C). The total dose of rescue analgesia consumed during the first 24 hours postoperatively was significantly lower in groups (M) than in group (D) and both groups showed lesser doses compared to group (C) Conclusion: We concluded that both MgSO4 and dexamethasone could prolong the postoperative duration and analgesic efficiency provided by the TAP block in cesarean sections. This further reduced the demands for postoperative rescue analgesia, with MgSO4 found to be more efficient than IV dexamethasone. Clinical Trial Registration Number: NCT04223128

scholarly journals Circumcision in children: postoperative analgesic efficiency of transversus abdominis plan block vs caudal epidural block: a prospective observational study

2021 ◽  
pp. 1
Keyword(s):  
Postoperative Pain ◽  
Observational Study ◽  
Postoperative Analgesia ◽  
Prospective Observational Study ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Significant Difference ◽  
Caudal Epidural

Background and objective: Circumcision is one of the most common operations and can cause postoperative pain, fear, and anxiety for children. This study aims to compare the effects of transversus abdominis plane (TAP) block and caudal epidural (CE) anesthesia on postoperative analgesia after circumcision in providing postoperative pain control. Methods: Eighty boys aged 1 to 14 years who underwent elective circumcision surgery under general anesthesia either with USG-guided TAP block or with CE block for postoperative analgesia were enrolled consecutively to this prospective observational study equally in each group. Postoperative pain scores and need for rescue analgesia were recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in mean age and Aldrete scores (p > 0.05). Body mass index (BMI) of the caudal block group was statistically lower than the TAP group (p < 0.05). While there was no statistically significant difference between the groups in 30th-minute VAS values (p > 0.05), the CE block group's 1st, 2nd, 4th, 8th, 12th, 18th, and 24th hour VAS values were statistically lower than the TAP block group's (p < 0.05). Conclusion: USG-guided TAB block under general anesthesia was not associated with lower postoperative pain scores and delayed rescue analgesia need compared with CE block in patients who underwent elective circumcision surgery. CE block provided superior analgesia than the USG-guided TAP block after elective circumcision surgery in this study.

Sign in / Sign up

Export Citation Format

Share Document