Use of ultrasound-guided subcostal transversus abdominis plane blocks in a pediatric patient with chronic abdominal wall pain

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery through the lateral abdominal wall pathway remains unknown. The study aimed to evaluate the analgesic efficacy of lateral TAP block for retroperitoneoscopic partial or radical nephrectomy. Method In this prospective, randomized, double-blind, placebo-controlled trial, eligible patients were randomized into two groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed with either 30 ml of 0.4% ropivacaine (Group T) or an equivalent volume of normal saline (Group C). The primary outcomes were opioid consumption during surgery and in the first 24 h after surgery. Secondary outcomes included postsurgical pain intensity immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 h after surgery, as well as recovery variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized (53 in Group T and 51 in Group C). Laparoscopic surgery was converted to open surgery in one patient of Group T; this patient was excluded from the outcome analysis. The opioid consumption during surgery (intravenous morphine equivalent dose: median 35.0 mg [interquartile range 18.0, 49.6] in Group C vs. 40.3 mg [20.9, 59.0] in Group T, P = 0.281) and in the first 24 h after surgery (10.8 mg [7.8, 21.7] in Group C vs. 13.2 mg [8.0, 26.6] in Group T, P = 0.311) did not differ significantly between groups. There were no significant differences between groups regarding the pain intensity at all time points after surgery and the recovery variables (all P > 0.05). Conclusions Our results showed that, in patients undergoing retroperitoneoscopic renal surgery, preoperative lateral TAP did not decrease intra- and postoperative opioid consumption, nor did it relieve pain intensity or promote postoperative recovery in the first 24 h after surgery. However, the trial might be underpowered. Trial registration This study was registered on November 4, 2017, in the Chinese Clinical Trail Registry with the identification number ChiCTR-INR-17013244.

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Neurolytic transversus abdominis plane block in the palliative treatment of intractable abdominal wall pain

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2011.04.010 ◽

2012 ◽

Vol 24 (1) ◽

pp. 58-61 ◽

Cited By ~ 3

Author(s):

Bryan Sakamoto ◽

Sanjay Kuber ◽

Kenneth Gwirtz ◽

Ahmed Elsahy ◽

Michael Stennis

Keyword(s):

Abdominal Wall ◽

Palliative Treatment ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Transversus Abdominis Plane ◽

Abdominal Wall Pain

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COMPARISON OF ROPIVACAINE AND BUPIVACAINE IN ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING LAPAROSCOPIC SURGERY

10.36106/paripex/8100231 ◽

2021 ◽

pp. 4-5

Author(s):

Patel Bhargavkumar Rameshbhai ◽

Kansagra Meetkumar Dhirajlal

Keyword(s):

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Sensory Blockade ◽

Analgesic Technique ◽

Transversus Abdominis Muscle

Transversus Abdominis Plane (TAP) Block is a regional analgesic technique. It provides analgesia after abdominal surgery.The anterior abdominal wall is innervated by nerve afferents that course through the transverses abdominis neurovascular fascial plane. TAP block allows sensory blockade of abdominal wall skin and muscles when local anesthetic deposited above transversus abdominis muscle (TAM).

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The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: A randomized controlled study

10.21203/rs.2.9718/v3 ◽

2019 ◽

Author(s):

Xue Li ◽

Zhen-Zhen Xu ◽

Xue-Ying Li ◽

Ting-Ting Jiang ◽

Zeng-Mao Lin ◽

...

Keyword(s):

Pain Intensity ◽

Abdominal Wall ◽

Analgesic Efficacy ◽

Opioid Consumption ◽

Transversus Abdominis ◽

Controlled Study ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Renal Surgery

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery through the lateral abdominal wall pathway remains unknown. The study aimed to evaluate the analgesic efficacy of lateral TAP block for retroperitoneoscopic partial or radical nephrectomy. Method In this prospective, randomized, double-blind, placebo-controlled trial, eligible patients were randomized into two groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed with either 30 ml of 0.4% ropivacaine (Group T) or an equivalent volume of normal saline (Group C). The primary outcomes were opioid consumption during surgery and in the first 24 hours after surgery. Secondary outcomes included postsurgical pain intensity immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 hours after surgery, as well as recovery variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized (53 in Group T and 51 in Group C). Laparoscopic surgery was converted to open surgery in one patient of Group T; this patient was excluded from the outcome analysis . The opioid consumption during surgery ( intravenous morphine equivalent dose: median 35.0 mg [interquartile range 18.0, 49.6] in Group C vs. 40.3 mg [20.9, 59.0] in Group T, P=0.281) and in the first 24 hours after surgery ( 10.8 mg [7.8, 21.7] in Group C vs. 13.2 mg [8.0, 26.6] in Group T , P=0.311) did not differ significantly between groups. There were no significant differences between groups regarding the pain intensity at all time points after surgery and the recovery variables (all P>0.05). Conclusions Our results showed that, in patients undergoing retroperitoneoscopic renal surgery, preoperative lateral TAP did not decrease intra- and postoperative opioid consumption, nor did it relieve pain intensity or promote postoperative recovery in the first 24 hours after surgery. However, the trial might be underpowered. Trial registration This study was registered on November 4, 2017, in the Chinese Clinical Trail Registry with the identification number ChiCTR-INR-17013244.

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The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: A randomized controlled study

10.21203/rs.2.9718/v2 ◽

2019 ◽

Author(s):

Xue Li ◽

Zhen-Zhen Xu ◽

Xue-Ying Li ◽

Ting-Ting Jiang ◽

Zeng-Mao Lin ◽

...

Keyword(s):

Pain Intensity ◽

Abdominal Wall ◽

Analgesic Efficacy ◽

Opioid Consumption ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Renal Surgery ◽

Postsurgical Pain

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery involving access through the lateral abdominal wall remains unknown. Therefore, the study aimed to evaluate the analgesic efficacy of lateral TAP block for retroperitoneoscopic partial or radical nephrectomy. Method In this prospective, randomized, double-blind, placebo-controlled trial, eligible patients were randomized into the intervention (T) or control (C) groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed preoperatively with 30 ml of 0.4% ropivacaine and an equivalent amount of normal saline in groups T and C, respectively. The primary outcomes were opioid consumption during surgery and in the first 24 h after surgery. Secondary outcomes were postsurgical pain intensity upon immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 h after surgery as well as recovery quality variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized: 53 and 51 in groups T and C, respectively. Laparoscopic surgery was converted to open surgery in one patient. Thus, he was excluded from the analysis. The median intraoperative and postoperative opioid consumption (oral morphine equivalent dose, o-MED) in the first 24 h after surgery were 105.0 and 32.5 mg in Group C, respectively, and the corresponding values in Group T were 121.0 and 39.7 mg, all of which were not significant (P = 0.284 and 0.311). Postsurgical pain intensity at all time points was comparable between the groups (all P > 0.05). Intergroup differences in the recovery quality variables were not significant (all P > 0.05). Conclusion Our findings demonstrated that preoperative lateral TAP could not decrease intraoperative or postoperative opioid consumption or pain intensity in the first 24 h after surgery, nor could it promote postoperative recovery in patients undergoing laparoscopic renal surgery through retroperitoneal access.

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Unilateral Transversus Abdominis Plane Block Catheter for the Treatment of Abdominal Wall Pain in Pregnancy

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000489494.57843.e9 ◽

2016 ◽

Vol 36 (3) ◽

pp. 167

Author(s):

E.C. Miller ◽

M. Szeto ◽

S. Boet

Keyword(s):

Abdominal Wall ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Transversus Abdominis Plane ◽

Abdominal Wall Pain ◽

In Pregnancy

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Neurolytic Transversus Abdominal Plane Block with Alcohol for Long-Term Malignancy Related Pain Control

January 2018 - Pain Physician ◽

10.36076/ppj.2014/17/e755 ◽

2014 ◽

Vol 6;17 (6;12) ◽

pp. E755-E760 ◽

Cited By ~ 1

Author(s):

Joseph C. Hung

Keyword(s):

Abdominal Wall ◽

Single Case ◽

Case Reports ◽

Case Series ◽

Rectus Muscle ◽

Transversus Abdominis ◽

Opioid Use ◽

Transversus Abdominis Plane ◽

Alcohol Injection ◽

Abdominal Wall Pain

There have been several case reports in the literature of neurolytic transversus abdominis plane (TAP) blocks being used for malignant abdominal wall pain. However, most used phenol as a neurolytic agent. We found only a single case report by Sakamoto using alcohol for TAP neurolysis. Unfortunately this patient passed away only 5 days after performance of the block. We attempt to extend upon the existing literature by describing neurolytic TAP blockade outcomes using alcohol on 3 cancer patients with metastatic disease to the abdominal wall. Two of our 3 patients had colorectal cancer invading the abdominal musculature. The third patient had a metastatic neuroendocrine nodule in the left rectus muscle. In our case series, all 3 patients had sustained and significant (greater than 50%) relief of abdominal wall pain after performing TAP neurolysis using alcohol. Ultrasound guidance was used for all blocks. The concentration of alcohol used varied from 33% to 77% between patients. Duration of relief lasted between 17 days and 6 months. Opioid use either decreased or remained relatively stable for prolonged periods of time after neurolysis. Other than one patient with transient post-procedure pain related to alcohol injection, there were no significant complications. Addition of a depo steroid for diagnostic TAP blockade prior to neurolysis did not appear to extend or provide additional analgesia. Based on our observations, TAP neurolysis using alcohol also offers a feasible option for longterm control of malignant abdominal wall pain. Further investigation is needed to determine if alcohol offers any significant advantage compared with phenol. Key words: Transversus abdominis plane block, TAP Block, cancer pain, neurolysis, alcohol, ultrasound, abdominal pain, interventional pain management

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The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: A randomized controlled study

10.21203/rs.2.9718/v5 ◽

2019 ◽

Author(s):

Xue Li ◽

Zhen-Zhen Xu ◽

Xue-Ying Li ◽

Ting-Ting Jiang ◽

Zeng-Mao Lin ◽

...

Keyword(s):

Pain Intensity ◽

Abdominal Wall ◽

Analgesic Efficacy ◽

Opioid Consumption ◽

Transversus Abdominis ◽

Controlled Study ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Renal Surgery

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery through the lateral abdominal wall pathway remains unknown. The study aimed to evaluate the analgesic efficacy of lateral TAP block for retroperitoneoscopic partial or radical nephrectomy. Method In this prospective, randomized, double-blind, placebo-controlled trial, eligible patients were randomized into two groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed with either 30 ml of 0.4% ropivacaine (Group T) or an equivalent volume of normal saline (Group C). The primary outcomes were opioid consumption during surgery and in the first 24 hours after surgery. Secondary outcomes included postsurgical pain intensity immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 hours after surgery, as well as recovery variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized (53 in Group T and 51 in Group C). Laparoscopic surgery was converted to open surgery in one patient of Group T; this patient was excluded from the outcome analysis . The opioid consumption during surgery ( intravenous morphine equivalent dose: median 35.0 mg [interquartile range 18.0, 49.6] in Group C vs. 40.3 mg [20.9, 59.0] in Group T, P=0.281) and in the first 24 hours after surgery ( 10.8 mg [7.8, 21.7] in Group C vs. 13.2 mg [8.0, 26.6] in Group T , P=0.311) did not differ significantly between groups. There were no significant differences between groups regarding the pain intensity at all time points after surgery and the recovery variables (all P>0.05). Conclusions Our results showed that, in patients undergoing retroperitoneoscopic renal surgery, preoperative lateral TAP did not decrease intra- and postoperative opioid consumption, nor did it relieve pain intensity or promote postoperative recovery in the first 24 hours after surgery. However, the trial might be underpowered. Trial registration This study was registered on November 4, 2017, in the Chinese Clinical Trail Registry with the identification number ChiCTR-INR-17013244.

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