Potential Advantages of Wireless Ultrasound-Guided Transversus Abdominis Plane Block for Pain Control Post-Abdominoplasty

2020 ◽  
pp. 074880682092982
Author(s):  
Alan Wong ◽  
Alexander D. J. Selsky ◽  
Alexander Zuriarrain
Keyword(s):  
Pain Control ◽  
Ultrasound Guidance ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Added Value ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Landmark Technique ◽  
Control Post

Transversus abdominis plane (TAP) block is a relatively new technique used to provide analgesia to the anterolateral abdominal wall following abdominal procedures. Transversus abdominis plane blocks can be performed using a blind/landmark technique or with ultrasound guidance. We report a 49-year-old woman who received a successful wireless ultrasound-guided TAP block during an abdominoplasty. Our case illustrates the potential advantages of a wireless ultrasound-guided TAP block versus a landmark-guided TAP block during an abdominoplasty. It also serves to promote the use of wireless ultrasound imaging when performing a TAP block to minimize risks of the procedure and achieve better pain control postoperatively. Further studies are needed to confirm the added value that ultrasound provides.

Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Post-Operative Pain Management after Cesarean Section

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Omar Mohamed Taha Elsafty ◽  
Hanan Mahmoud Farag Awad ◽  
Mohamed Saleh Ahmed ◽  
Ahmed Elkholy Mahdy
Keyword(s):  
Postoperative Pain ◽  
Cesarean Section ◽  
Pain Control ◽  
Early Mobilization ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Quadratus Lumborum

Abstract Background Cesarean section rate increased those days and postoperative pain control. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using multimodal analgesic therapy, preference for regional techniques, avoidance of sedatives, non-invasive ventilation with supplemental oxygen and early mobilization. Objectives The aim of this study was to assess the analgesic efficacy of ultrasound-guided trans-muscular QLB compared with TAP block after cesarean section surgeryperiod regarding pain relief, provision of comfort, and improved respiratory functions. Patients and Methods After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, female patients were included in the study, and were divided into three groups (n = 20; each); group QLB and group TAP. Group QLB: Patients (n = 20) of this group received bilateral ultrasound-guided QLB after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%, Group TAP: Patients (n = 20) of this group received bilateral ultrasound-guided TAP block after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%. Results The current study also measured and compared postoperative VAS score and firs time to rescue analgesia and the total amount of opioid (pethidine) given in the first 24 hours with the standard deviation for each of the two groups studied we found that TAP patients had the highest values compared to the QLB group. This is mainly due to the extension of the local anesthetic agent beyond the transverse abdominal plane to the thoracic paravertebral space, which then results in more analgesia, even somatic and visceral pain control. Conclusion Quadratus lumborum block was the most effective technique in providing analgesia after cesarean section without associated hemodynamic instability in comparison to transversus abdominis plane block and even more time covering to rescue opioid.

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

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).

scholarly journals Bilateral Ultrasound-Guided Erector Spinae Plane Block Versus Transversus Abdominis Plane Block on Postoperative Analgesia after Total Abdominal Hysterectomy

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. 375-382
Author(s):  
Alshaimaa Abdel Fattah Kamel
Keyword(s):  
Postoperative Analgesia ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Transversus Abdominis Plane Block ◽  
Erector Spinae ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Erector Spinae Plane Block

Background: Transversus abdominis plane (TAP) blocks provide postoperative pain relief after various abdominal surgeries. Recently, erector spinae plane (ESP) block has obtained vast attention due to its simplicity and usage in truncal procedures. Objectives: This study aims to compare the ultrasound-guided bilateral ESP block versus bilateral TAP block on postoperative analgesia after open total abdominal hysterectomy. Study Design: A prospective, double-blinded, randomized, controlled, clinical trial. Setting: Zagazig University Hospitals. Methods: After ending of surgical procedure and before reversing of the muscle relaxant, 48 women were randomly allocated into 2 equal groups: erector spinae (ES) group received bilateral ultrasound-guided ESP block with 20 mL of bupivacaine 0.375% plus 5 ug/mL adrenaline (1:200000) in each side at the level of T9, and transversus abdominis (TA) group received bilateral ultrasound-guided TAP block with the same volume of bupivacaine plus adrenaline. Results: Visual Analog Scale scores at 30 minutes, 2, 4, 6, 8, 12, 16, 20, and 24 hours were statistically significantly lower in the ES group compared with the TA group. The time for requirement of first morphine was highly statistically significantly prolonged in the ES group (14.81 ± 3.52 hours) compared with the TA group (10.58 ± 2.35 hours). The total amount of morphine consumption in 24 hours postoperatively was statistically significantly decreased in the ES group; P = 0.01. Incidence of postoperative nausea and vomiting was higher but statistically insignificant in the TA group than the ES group. There were statistically significant numbers of unsatisfied patients (4) in the TA group compared with the ES group (no patient). Limitations: Sensorial evaluation of patients was not performed because both blocks had been done under general anesthesia but did not affect outcome. Therefore we recommend further studies comparing between both blocks. Conclusions: Bilateral ultrasound-guided ESP block provides more potent and longer postoperative analgesia with less morphine consumption than TAP block after open total abdominal hysterectomy. Key words: Abdominal hysterectomy, transversus abdominis plane block, erector spinae plane block, postoperative analgesia

Impact of simulation-based anesthesiology training using an anesthetized porcine model for ultrasound-guided transversus abdominis plane block

2018 ◽  
Author(s):  
Sang Jun Park ◽  
Hyun Joo Kim ◽  
Hun-Mu Yang ◽  
Kyung Bong Yoon ◽  
Ki-Young Lee ◽  
...  
Keyword(s):  
Training Session ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Multiple Choice Questions ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Model Animal ◽  
Simulation Based ◽  
The Impact

Abstract Background: Anesthetized pigs may be useful for training with regional anesthesia techniques. This model animal was used to assess the impact of simulation-based training for ultrasound-guided transversus abdominis plane (TAP) block. Methods: In this prospective study, 23 participating residents (10 in their second year, 13 in their third year) underwent simulation-based training for ultrasound-guided TAP block. The residents completed standard questionnaires comprising ten multiple-choice questions regarding essential general knowledge of abdominal ultrasound and TAP block before and after the training session. On a five-point Likert scale, they reported their levels of comfort with the use of ultrasound and block equipment, subject/operator positioning, proper block technique, image documentation, needle handling, and anxiety, as well as their overall confidence with the procedure. Results: Compared with those before training, the comfort levels of the residents significantly improved for all measures, except needle handling (all P < 0.05). The participants also indicated significantly reduced anxiety for performing the TAP block technique (P < 0.05). Conclusion: The use of anesthetized pigs in simulation-based training for the ultrasound-guided TAP block procedure improves the procedural knowledge and confidence while reducing the associated anxiety in anesthesiology trainees. Keywords: Porcine; simulation-based training; transversus abdominis plane block

Efficacy of The Subcostal Transversus Abdominis Plane Block In Laparoscopic Cholecystectomy: A Comparison With Conventional Port- Site Infiltration

2020 ◽  
Vol 2 (2) ◽  
pp. 42-47
Author(s):  
Kalpana Kharbuja ◽  
Jeevan Singh ◽  
Sangina Ranjit ◽  
Barun Bahadur Pradhan ◽  
Ashish Shrestha ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visual Analogue Score ◽  
Transversus Abdominis Plane Block ◽  
Opioid Consumption ◽  
Port Site ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Post Operative Pain

Introduction: Pain experienced following laparoscopic cholecystectomy derives significantly from incision made in anterior abdominal wall. Many patients experience moderate to severe pain following laparoscopic cholecystectomy. This study aimed to compare the efficacy of ultrasound guided bilateral subcostal transversus abdominal plane (TAP) block with port-site infiltration for post-operative analgesia after laparoscopic cholecystectomy. Methods: Sixty patients undergoing laparoscopic cholecystectomy were randomly allocated to two groups to receive port-site infiltration of local anaesthesia or ultrasound guided subcostal TAP block at the end of surgery before extubation. All patients received 1 gm paracetamol intravenously 8 hourly. Post-operative pain was assessed using visual analogue score at 0,1,2,4,8,16 and 24 hours. Time to first analgesic requirement and total opioid consumption over 24 hours were recorded. Results: Ultrasound guided bilateral subcostal transversus abdominis plane block significantly reduced post-operative pain score compared to port site infiltration. We observed statistically significant differences in visual analogue score between two groups at all other time frame. The 24 hours opioid consumption was less in Subcostal TAP (136±66.31μg VS 202±80.58μg, p=0.001). Time for rescue analgesia was prolonged in patient receiving subcostal TAP (3.63±2.09 hrs VS 1.73±1.60 hrs, p=0.0002). Conclusion: Ultrasound guided bilateral subcostal transversus abdominal block provides superior post-operative analgesia and reduced opioid consumption after laparoscopic cholecystectomy compared to port-site infiltration.  

scholarly journals The Analgesic Effectiveness of Ipsilateral Transversus Abdominis Plane Block in Adult Patients Undergoing Appendectomy: A Prospective Randomized Controlled Trial

2017 ◽  
Vol 13 (4) ◽  
pp. 361-365 ◽  
Author(s):  
A Ghimire ◽  
B. Bhattarai ◽  
J.N. Prasad ◽  
S.P. Shah
Keyword(s):  
Postoperative Analgesia ◽  
Controlled Trial ◽  
Isotonic Saline ◽  
Transversus Abdominis Plane Block ◽  
Adult Patients ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Visceral Injury ◽  
Landmark Technique

Background Transversus abdominis plane block (TAP) has been shown to produce effective pain relief following lower abdominal surgeries but is yet to be routinized in different type of surgeries including appendectomy. The main risk of visceral injury can be logically avoided when the block is performed with the abdomen open using landmark technique in the absence of ultrasound guidance.Objective To assess the effectiveness of TAP block with bupivacaine for postoperative analgesia using landmark technique (performed with the abdomen open) in adult patients undergoing appendectomy.Method Forty patients undergoing appendectomy were randomized to undergo ipsilateral TAP block with bupivacaine (n=20) versus control (n=20) in addition to standard postoperative analgesia. All patients received standard general anaesthesia. The block was performed using the landmark technique with 20 ml of 0.5% bupivacaine or isotonic saline on ipsilateral side just before abdominal closure. Pain severity was measured using Visual Analogue Scale (VAS). Tramadol 50 mg was administered as rescue analgesic intravenously when VAS was four or more postoperatively. The duration of analgesia and the requirement of tramadol in 24 hours postoperatively were recorded.Result Mean duration of analgesia in the TAP block with bupivacaine was longer as compared with placebo (724.00±299.07 min vs 168.25±55.18 min; p< 0.01). The TAP block with bupivacaine compared with saline significantly reduced postoperative VAS pain scores. Mean tramadol requirement in the first 24 hours was also reduced (42.50±37.25 mg vs 120.00±55.18 mg; p<0.01). There were no significant complications attributable to the TAP block.Conclusion Ipsilateral TAP block with bupivacaine using landmark technique with the abdomen open in appendectomy provides effective postoperative analgesia and opioids sparing effect.

scholarly journals Effectiveness of perineural and intravenous dexamethasone added to bupivacaine for transversus abdominis plane block in post-cesarean delivery pain control: a prospective cohort study, 2019

2020 ◽  
Author(s):  
Bedru Jemal ◽  
Abebayehu Zemedkun ◽  
Wosenyeleh Admasu ◽  
Sileshi Abiy ◽  
Simeneh Molla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Delivery ◽  
Prospective Cohort ◽  
Pain Control ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Chi Square ◽  
Analgesic Consumption

Abstract Background Caesarean delivery (CD) has been one of the most frequently performed major surgical interventions, and causes severe postoperative pain. Abdominal field blocks like TAP block are mostly preferred as post-operative analgesia for this operation. Using different adjuvants like dexamethasone by different routes increases the quality and duration of block and maximizes patient satisfaction. The objective of this study was to compare the effectiveness between perineural and intravenous dexamethasone as an adjuvant on bilateral transversus abdominis plane block for post cesarean delivery pain control. Methodology An institutional based prospective cohort study was conducted on 87 patients. Study participants were selected by systematic random sampling technique. Data collection methods include preoperative chart review, intraoperative observation and postoperative patient interview at 4 th , 6 th , 8 th , 12 th and 24 th hours. Sociodemographic variable were analyzed by ANOVA and chi square test. Kruskal Wallis with post hoc analysis was used to compare post-operative severity of pain score and cumulative analgesic consumption. Time to first analgesic request was analyzed using Kaplan Meier survival analysis with log rank. Categorical variable were analyzed by chi square. Result Time to first analgesic request was significantly longer in TAP-IVD and TAP-PD compared to TAP alone (p < 0.05). The postoperative NRS score at rest and on coughing were significantly lowered in TAP-PD and TAP-IVD group compared to TAP alone group (p <0.05).The total analgesic consumption in the first 24h was significantly lower in TAP-IVD and TAP-PD group compared to TAP alone group (p < 0.05). Conclusion and recommendation dexamethasone 8mg both intravenously and perineurally is effective adjuvant to bupivacaine on bilateral TAP block with prolonged and potent analgesia and reduced analgesic consumption. Based on our finding we recommend use of dexamethasone as an adjuvant to bupivacaine on bilateral transversus abdominis plane block.

scholarly journals Ergonomic Consideration of Ultrasound-guided Transversus Abdominis Plane Block between Experienced and Novice Anaesthesiologists

2020 ◽  
Author(s):  
Subbulakshmi Sundaram ◽  
. Dhakshinamoorthy ◽  
. Srinivasan ◽  
Ashok Swaminathan
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Regional Anaesthesia ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Significant Difference

Introduction: Ergonomics is the science of interaction between human and working environment. The growing use of Ultrasound (US) in regional anaesthesia has created the need to consider ergonomic aspects relevant to regional anaesthesia. Aim: To analyse ergonomic consideration of Ultrasound-guided (USG) Transversus Abdominis Plane block (TAP) between experienced and novice anaesthesiologists for Inguinal Hernia Repair. Materials and Methods: A prospective observational study was conducted where 10 experienced (E) (performed >20 TAP block procedures) and 11 novice (N) (performed at least 5 TAP block procedures) anaesthesiologists participated. The study included 21 patients of ASA I and II posted for inguinal hernia repair under spinal anaesthesia. USG TAP block was given after the completion of surgical procedure. Patient, operator and environmental factors were observed and measured using a measuring scale and photographs and goniometer. Results: Performance of USG TAP block was ergonomically suboptimal and varied among the operators. A 7E and 2N performed the procedure in sitting position and others in standing position, which was statistically significant (p=0.03) adjustment of tables were done by 7E and 2N operators, the difference statistically significant (p=0.03). A 2E and 8N flexed their back and 7E kept their neck flexed less than 20° and 9N kept their neck flexed more than 20° which was statistically significant (p=0.001). Only 10E and 5N kept Ultrasound machine in front in line and others were not, which was statistically significant (p=0.012). There was no significant difference between the groups in terms of side of the block performed, location of the procedure, position of assistants and trolleys in relation to operator during the procedure. Conclusion: It was found that the performance of USG TAP block was ergonomically sub-optimal in the setting described. compared to novice, experienced operators performed better. Inclusion of ergonomic concepts in academic training

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