A Randomized Controlled Trial of Comparing Ultrasound-Guided Transversus Abdominis Plane Block with Local Anesthetic Infiltration in Peritoneal Dialysis Catheter Implantation

2017 ◽  
Vol 45 (1-3) ◽  
pp. 8-14 ◽  
Author(s):  
Qi Li ◽  
Xiaohong Tang ◽  
Tian Tao ◽  
Wenjuan Zhang ◽  
Wei Qin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Local Anesthetic ◽  
Transversus Abdominis ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Anesthesia Technique ◽  
Esrd Patients ◽  
Local Anesthetic Infiltration

Background: The ultrasound-guided transversus abdominis plane (TAP) block has been demonstrated as a useful analgesia technique in lower-abdomen surgeries. We hypothesized that it could be the principal anesthesia technique for end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD) catheter (PDC) implantation using the open dissection method. Methods: This was a single-center, prospective, randomized, and double-blinded study. All eligible patients were randomized into 2 groups: the TAP block group (n = 20) and the local anesthetic infiltration (LAI) group (n = 20). Results: Compared with the LAI group, the TAP block group revealed a remarkably lower visual analogue score, lower switching rate into general anesthesia, higher satisfaction rate, and less rescuing analgesic consumption during operation (p < 0.05). Both PD- and anesthesia-related complications were rare in the 4-week follow-up. Conclusions: The ultrasound-guided TAP block had better analgesic effect than LAI and can be used as a principal anesthesia technique for PDC implantation in ESRD patients without previous abdominal surgery.

Peritoneal Dialysis Catheter Placement Using an Ultrasound-Guided Transversus Abdominis Plane Block

2015 ◽  
Vol 39 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Dean Markić ◽  
Božidar Vujičić ◽  
Mladen Ivanovski ◽  
Kristian Krpina ◽  
Antun Gršković ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
General Anesthesia ◽  
Regional Anesthesia ◽  
Catheter Placement ◽  
Transversus Abdominis ◽  
Peritoneal Dialysis Catheter ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Anesthesia Technique

Background: Peritoneal dialysis (PD) catheter placement is usually performed using general or local anesthesia. We present our PD catheter placement experience using an ultrasound-guided transversus abdominis plane (TAP) block, which is a regional anesthesia technique. Methods: In this study, we analyzed 33 patients from our center with ESRD who underwent PD catheter placement using a TAP block between June 2011 and April 2014. Results: The TAP block was successful for 29/33 (87.9%) patients. Four patients (12.1%) had pain at the incision site and required general anesthesia. There were no anesthesia-, surgery- or catheter-related complications. Conclusion: ESRD patients have a substantial number of comorbidities that can be negatively influenced by general anesthesia. Because regional anesthesia has no systemic effect, this procedure could be recommended for this group of patients. A TAP block is an effective, safe method and can be used as the principal anesthesia technique for PD catheter placement.

Ultrasound-Guided Oblique Sub-Costal Transversus Abdominis Plane Block as the Principal Anesthesia Technique in Peritoneal Dialysis Catheter Implantation and Plasma Ropivacaine Concentration Evaluation in Esrd Patients: A Prospective, Randomized, Double-Blinded, Controlled Trial

2018 ◽  
Vol 38 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Zi Li ◽  
Xiao Hong Tang ◽  
Qi Li ◽  
Wen-juan Zhang ◽  
Tian Tao ◽  
...  
Keyword(s):  
Transversus Abdominis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Anesthesia Technique ◽  
End Stage ◽  
Esrd Patients ◽  
Venous Plasma

BackgroundThe ultrasound-guided transversus abdominis plane (TAP) block is generally used for analgesia but not for anesthesia. A TAP block has a partial analgesic effect on the parietal peritoneum in abdominal surgeries. We hypothesized that an ultrasound-guided oblique subcostal TAP block, used as the principal anesthesia technique, could provide a better anesthetic effect on peritoneum stimulation in peritoneal dialysis catheter (PDC) implantation in end-stage renal diseases (ESRD) patients than local anesthetic infiltration (LAI).MethodsEnd-stage renal disease patients undergoing PDC implantation were randomized into 3 groups: LAI Group, unilateral TAP group (Uni-TAP Group) and bilateral TAP group (Bi-TAP Group). A 40-mL dose of 0.25% ropivacaine was used for the regional block (LAI or TAP). The quality of anesthesia, visual analogue scale (VAS) of pain, cumulative rescuing sufentanil consumption, and venous plasma ropivacaine concentrations were compared among the 3 groups.ResultsSixty-nine patients were enrolled, and higher ‘Satisfied’ anesthesia rates from nephrologists and patients were recorded in the 2 TAP groups, compared with the LAI Group. Significantly lower VAS scores were observed in the Uni-TAP Group at a majority of time points compared with the LAI Group. Less cumulative rescuing sufentanil was used in the 2 TAP groups (2.5 ± 2.7 and 3.0 ± 2.8 μg, respectively) compared with the LAI Group (5.8 ± 2.6 μg, p < 0.05). The median peak venous plasma ropivacaine concentrations were below the reported toxic threshold in all 3 groups.ConclusionsAs the principal anesthesia technique, an ultrasound-guided unilateral oblique subcostal TAP block with 40 mL of 0.25% ropivacaine provided better anesthetic effect in PDC implantations in ESRD patients than LAI.

scholarly journals Transversus abdominis Plane Block for Improved Early Postoperative Pain Management after Periacetabular Osteotomy: A Randomized Clinical Trial

2021 ◽  
Vol 10 (3) ◽  
pp. 394
Author(s):  
Jannis Löchel ◽  
Viktor Janz ◽  
Vincent Justus Leopold ◽  
Michael Krämer ◽  
Georgi I. Wassilew
Keyword(s):  
Postoperative Pain ◽  
Periacetabular Osteotomy ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Control Group ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Pain Scores

Background: Patients undergoing periacetabular osteotomy (PAO) may experience significant postoperative pain due to the extensive approach and multiple osteotomies. The aim of this study was to assess the efficacy of the transversus abdominis plane (TAP) block on reducing opioid consumption and improving clinical outcome in PAO patients. Patients and Methods: We conducted a two-group randomized-controlled trial in 42 consecutive patients undergoing a PAO for symptomatic developmental dysplasia of the hip (DDH). The study group received an ultrasound-guided TAP block with 20 mL of 0.75% ropivacaine prior to surgery. The control group did not receive a TAP block. All patients received a multimodal analgesia with nonsteroidal anti-inflammatory drugs (NSAID) (etoricoxib and metamizole) and an intravenous patient-controlled analgesia (PCA) with piritramide (1.5 mg bolus, 10 min lockout-time). The primary endpoint was opioid consumption within 48 h after surgery. Secondary endpoints were pain scores, assessment of postoperative nausea and vomiting (PONV), measurement of the quality of recovery using patient-reported outcome measure and length of hospital stay. Forty-one patients (n = 21 TAP block group, n = 20 control group) completed the study, per protocol. One patient was lost to follow-up. Thirty-three were women (88.5%) and eight men (19.5%). The mean age at the time of surgery was 28 years (18–43, SD ± 7.4). All TAP blocks were performed by an experienced senior anaesthesiologist and all operations were performed by a single, high volume surgeon. Results: The opioid consumption in the TAP block group was significantly lower compared to the control group at 6 (3 mg ± 2.8 vs. 10.8 mg ± 5.6, p < 0.0001), 24 (18.4 ± 16.2 vs. 30.8 ± 16.4, p = 0.01) and 48 h (29.1 mg ± 30.7 vs. 54.7 ± 29.6, p = 0.04) after surgery. Pain scores were significantly reduced in the TAP block group at 24 h after surgery. There were no other differences in secondary outcome parameters. No perioperative complication occurred in either group. Conclusion: Ultrasound-guided TAP block significantly reduces the perioperative opioid consumption in patients undergoing PAO.

Peritoneal Dialysis Catheter Surgery Using Transversus Abdominis Plane Block

2017 ◽  
Vol 37 (4) ◽  
pp. 429-433 ◽  
Author(s):  
Dean Markic ◽  
Božidar Vujičić ◽  
Mladen Ivanovski ◽  
Kristian Krpina ◽  
Antun Gršković ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Placement ◽  
Transversus Abdominis ◽  
Peritoneal Dialysis Catheter ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Effective Technique ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

BackgroundPeritoneal dialysis (PD) catheter surgery can be performed using regional anesthesia. We present our PD catheter placement and extraction experience using ultrasound-guided transversus abdominis plane (TAP) block.MethodsIn the present study, we analyzed 74 patients from our center with end-stage renal disease (ESRD) who underwent PD catheter placement (60 patients) and removal (14 patients) using a TAP block between June 2011 and December 2015.ResultsThe TAP block was successful for 55/60 (91.7%) patients (insertion) and 13/14 (92.9%) patients (extraction). Other patients had pain at the incision site and required general anesthesia. There were no anesthesia-, surgery- or PD catheter-related complications.ConclusionThe TAP block is a safe and effective technique not only for high-risk ESRD patients but for all patients undergoing PD catheter placement or extraction.

EFFICACY OF TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POST CESAREAN DELIVERY ANALGESIA

2018 ◽  
Vol 8 (5) ◽  
pp. 37-41
Author(s):  
Minh Nguyen Van ◽  
Nga Bui Thi Thuy ◽  
Thinh Tran Xuan
Keyword(s):  
Caesarean Section ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Morphine Consumption ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Pain Scores

Background: The transversus abdominis plane block (TAP block), a regional block, provides effective analgesia after lower abdominal surgeries. The objective of this study was to assess whether transversus abdominis plane block is effective as part of multimodal pain management following Cesarean section. Materials and Method: Totally, 60 ASA I and II parturients for Cesarean section via Pfannenstiel incision under spinal anesthesia were randomly allocated to either the TAP block group or the control. The TAP block group received a landmark-orientated, bilateral TAP block with 0.25% levobupivacain 17,5ml each side in the triangle of Petit. Postoperative pain treatment followed the same protocole for both groups with 1gram paracetamol intravenously and received patrient-controlled analgesia with intravenous morphine. The time to first request of analgesic, morphine consumption, visual analogue scale (VAS) pain scores and side effects were scored at 2, 4, 6, 8, 12 h postoperatively. Results: The time to first request of analgesic was longer, morphine consumption was lower in TAP group than in the control (p < 0.05). Visual analogue scale (VAS) pain scores at rest and on mouvement were similar in two groups at 2h, but lower in TAP group from 4h (p < 0.05). No severe adverse effects were detected in two groups. Conclusion: TAP block prolonged the time to fisrt request of analgesic and reduced morphine consumption, the VAS pain scores significantly both at rest and on mouvement. Therefore, TAP block is feasible and effective as part of a multimodal analgesia regimen after Caesarean section. Key words: Caesarean section, multimodal pain management, transversus abdominis plane 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.

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