Laparoscopic-Guided Ropivacaine Trocar-Site Infiltration Can Improve Post-Operative Pain Control after Laparoscopic Adrenalectomy

2021 ◽  
pp. 155335062110579
Author(s):  
Giuseppe Cavallaro ◽  
Andrea Polistena ◽  
Luigi Petramala ◽  
Sergio Gazzanelli ◽  
Daniele Crocetti ◽  
...  
Keyword(s):  
Pain Control ◽  
Laparoscopic Adrenalectomy ◽  
Transversus Abdominis ◽  
Trocar Site ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Group A ◽  
Laparoscopic Assisted

Background There is no consensus on pain control in patients undergoing laparoscopy; nowadays, conventional therapy may be improved by transversus abdominis plane block. The aim of this evaluation is to investigate the role of laparoscopic-assisted trocar-site ropivacaine infiltration during adrenalectomy in pain control Methods This is a retrospective evaluation of a prospectively maintained database including patients undergoing adrenalectomy. Patients were divided into 2 groups: Group A patients received laparoscopic-assisted trocar-site infiltration of 7.5 mg/mL ropivacaine and Group B patients did not receive any infiltration. All patients received a 24-hour infusion of 20 mg morphine; pain was checked at 6, 24, and 48 hours after surgery by Visual Analogue Scale (VAS) score. A rescue analgesia by was given if VAS score was > 4 or on patient request. Results No differences in operative time, complications, and post-operative stay and no complications related to trocar-site infiltration were found. 6-hour and 48-hour VAS scores were not found to be significantly different between groups, even if a slight decrease in VAS score in Group A was reported. Group A showed significant reduction in VAS score at 24 hours (2.44 +/− .41 vs 3.01 +/− .78, P < .005) and in the number of patients requiring further analgesic drugs administration (40.6% vs 57.8%, P < .005) Conclusions Laparoscopic-guided trocar-site ropivacaine infiltration can be considered safe and effective in the management of post-operative pain and in the reduction of analgesic need in patients undergoing laparoscopic adrenalectomy. The retrospective nature of the study and the lack of a consistent series of patients require further evaluations.

Transversus Abdominis Plane Block Vs. Paravertebral Block for Post-Operative Analgesia Following Inguinal Herniorrhaphy - A Cross-Sectional North Indian Sub-Population Study

2021 ◽  
Vol 8 (31) ◽  
pp. 2880-2884
Author(s):  
Trilok Chand ◽  
Amrita Gupta ◽  
Avanish Kumar Saxena ◽  
Pulkit Agarwal ◽  
Shanu Maheshwari
Keyword(s):  
Inguinal Hernia ◽  
Demographic Data ◽  
Paravertebral Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia ◽  
Inguinal Herniorrhaphy ◽  
Vas Score ◽  
Post Operative Pain

BACKGROUND Inguinal hernia is a frequently encountered surgical problem. General anaesthesia carries the risk of possible airway complications. Regional blocks improve acute post-operative pain, decrease post-operative visual analogue scale (VAS) score and patient can mobilise early. The purpose of this study was to compare the effectiveness of transversus abdominis plane (TAP) block vs. paravertebral (PVB) block for post-operative analgeia in inguinal hernia surgeries. METHODS We conducted a research on 64 patients of age > 18 years with American society of Anaesthesiologists (ASA I – III) to undergo unilateral inguinal herniorrhaphy. Patients were randomized into two groups. Group T received TAP block in which 20 ml of 0.25 % bupivacaine was injected and Group P underwent PVB in which 5 ml of bupivacaine (0.25 %) at each segment from T10-L1 was injected slowly (total dose of 20 ml). Post-operative VAS score, time for first rescue analgesia, total diclofenac requirement, total anti-emetic requirement and complications if any was noted. RESULTS The demographic data of both the groups were comparable. Also, pre and postoperative heart rate, blood pressure, IV fluids, ephedrine use, operative time and complications were statistically insignificant. As compared to group T, group P had lower VAS score from 2nd – 12th hour which was statistically significant (P < 0.05). Although more time is required to perform paravertebral block but the time for request of first rescue analgesia was quite prolonged in paravertebral block. Time of ambulation in group P was significantly lower than group T. CONCLUSIONS PVB requires more time to perform due to multiple site of injection, the comparison of both techniques in the present study revealed that PVB showed relatively higher efficacy in the management of post-operative pain, early ambulation and had significant reduction in dose requirement of additional analgesia (diclofenac) and antiemetics (ondansetron) over tap block. KEYWORDS Paravertebral Block, Transversus Abdominis Block, Inguinal Hernia

scholarly journals EARLY RECOVERY FOLLOWING ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK (TAP) IN ABDOMINAL CONTOURING SURGERIES

2020 ◽  
Vol 8 (10) ◽  
pp. 1227-1231
Author(s):  
Nawaf Naif Alotaibi ◽  
◽  
Aljohara Mohmoud Hamza ◽  
Sari Monzer Rabah ◽  
Tawheed Ahmad ◽  
...  
Keyword(s):  
Demographic Characteristics ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Early Recovery ◽  
Vas Score ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background:The transversus abdominis plane (TAP) block is a well-known regional nerve block that is used for the pain control after various inguinal andabdominal surgeries. The most effective and well known method of administering the TAP block is under ultrasound guidance.Till now only few studies have evaluated analgesic efficacy of TAP block in Abdominoplastysurgical procedure, in which post-operative pain is a major concern for both surgeon as well for the patient. Objectives:We conducted retrospective cohort study to assess efficacy of ultrasound-guided bilateral TAP block, in controlling post-operative pain in abdominoplasty patients. Methods:Sixty Patients who had undergone Lipoabdominoplasty procedurewere studied retrospectively. The patients who had received TAP block were assigned as groups A and those patients who had not received any TAP block were assigned as group B, with thirty Patients in each group.The patients in two groups were compared for their demographic characteristics, pain intensity on mobilization, time to first rescue analgesic dose (visual analog scale (VAS) score ≥ 5 or on demand), opioid consumptionand incidence of nausea-vomitingepisodes during first post-operative 24 hours. Results:The patients in two groups were similar in demographic characteristics. Patients in group A (TAP block group) had required significantly smaller mean dose of postoperative opioids (Group A: 5mg Group B: 75 mg P = <0.000) and hadsignificantly longer mean time of first request for analgesic medication (Group A: 8 hours 11 minutes Group B: 1 hours 20 minutes P = <0.000).Median VAS score on mobilization was significantly lower in Group A(group A: 1 Group B: 5).Only Three patients in group A as compared to 18 patients in group B had experienced nausea and vomiting in post-operative period. Conclusions:The ultrasound guided TAP block provide more effective analgesia after Lipoabdominoplasty, which allows more comfortable early post-operative mobilization, decreases opioid requirement as well as opioid related side-effects, Therefore ultrasound guided TAP block should be considered in most of lipoabdominoplasty patients for better patient experience and outcome.

scholarly journals A Comparative Study of Effectiveness of Ultrasound-Guided Transversus Abdominis Plane (TAP) Block vs Epidural Analgesia for Post-Operative Pain Relief in Lower Abdominal Surgeries

2020 ◽  
Vol 5 (1) ◽  
pp. 103-108
Author(s):  
Santosh Bhagasra ◽  
Neelam Meena ◽  
Vikas Rajpurohit
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Epidural Group ◽  
Abdominal Incision ◽  
Rescue Analgesia ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Background: An increase in the use of regional anesthesia techniques for postoperative pain relief for analgesia following lower abdominal surgeries. Epidural anesthesia considered as the "gold standard" has been established to provide excellent analgesia as well as attenuation of neurogenic contribution to inflammation. The TAP block provides reliable somatic analgesia in lower abdominal incision surgeries. Use of ultrasound helps incorrect localization of the plane and accurate placement of the needle and catheter.Subjects and Methods:In TAP group under USG guidance 20 ml 0.2% Inj. Ropivacaine was deposited on each side of the abdominal wall. In Epidural group 10 ml of 0.2% Inj. Ropivacaine was administered at skin closure.Results:Systolic and diastolic blood pressure levels were significantly lower in group B as compared to group A (p<0.05). . VAS score was significantly higher in group B as compared to group A (P<0.05). It was observed that a significantly higher number of patients in epidural group required rescue analgesia and at higher dosages (p<0.05).Conclusion:TAP block has almost no complications, keeps the patient hemodynamically stable and offers a good early postoperative analgesia (till 24 hours) when compared to a more accepted modality like epidural analgesia.

scholarly journals Comparative Evaluation of Tramadol Wound Infiltration over Bupivacaine for Postoperative Analgesia in Children Undergoing Inguinal Herniotomy and Orchidopexy

JMS SKIMS ◽  
2011 ◽  
Vol 14 (2) ◽  
pp. 52-55
Author(s):  
Abdul Qayoom Lone ◽  
Nazia Nazir ◽  
Shehnaz Gilani ◽  
Mohammad Ommid ◽  
Showkat H Nengroo ◽  
...  
Keyword(s):  
Saline Group ◽  
Good Choice ◽  
Controlled Study ◽  
Wound Infiltration ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Elective Repair ◽  
Group A ◽  
Group B ◽  
Inguinal Herniotomy

BACKGROUND: Recent clinical studies have demonstrated that children experience a similar severity of post operative pain as adults and that even preterm infants demonstrate alterations in heart rate, blood pressure and oxygen saturation in response to pain. OBJECTIVE: To study the advantage of tramadol wound infiltration over bupivacaine on post operative pain relief in children following inguinal herniotomy and orchiodopexy METHODS: In this prospective single blinded randomized controlled study, 705 children aged between 1–7 years undergoing elective repair of unilateral inguinal hernia and orchiodopexy were randomly divided into 3 groups of 25 each. Group A (Tramadol) à wound infiltration with 2mg/Kg Tramadol in 0.2ml/Kg saline, Group B (Bupivacaine) à wound infiltration with 0.2ml/Kg of 0.25% of Bupivacaine and Group C (Tramadol i/m) à 2mg/Kg tramadol intra muscularly 20 minutes before the end of surgery. Children were assessed post-anesthesia for pain score and discharged from Post Anesthesia Care Unit when they achieved a score of 10. RESULTS: Group A had lower pain scores than group B and C for the first 24 hours in the postoperative period. The other two parameters pulse rate and respiratory rate were also lower in group A. Moreover use of rescue analgesia was significantly lower in group A. CONCLUSION: Wound infiltration with tramadol is a good choice for post operative analgesia in children undergoing inguinal herniotomy and orchidopexy. JMS 2011;14(2):52-55

scholarly journals Tramadol or Nalbuphine; Which One is Superior for Analgesia in Post-Operative Period after Percutaneous Nephrolithotomy

2021 ◽  
Vol 15 (1) ◽  
pp. 51-54
Author(s):  
Muhammad Sheraz Javed ◽  
◽  
Ghulam Mehboob Subhani ◽  
Muhammad Akmal ◽  
Muhammad Irfan Munir ◽  
...  
Keyword(s):  
Pain Control ◽  
Rating Scale ◽  
Randomized Study ◽  
Rescue Analgesia ◽  
Post Operative Period ◽  
High Prevalence ◽  
Group A ◽  
Group B ◽  
Medical University ◽  
Pain Rating Scale

Background: Kidney stones has got high prevalence worldwide especially in our part of world and per-cutaneous nephrolithotomy (PCNL) is gold standard operative modality for renal stone management. Pain control after PCNL is the most important task for treating surgeon as effective pain control causes smooth patient recovery in post-operative period. For analgesia, many drugs can be used, out of which tramadol and nalbuphine always been in comparison for effective analgesic activity. Objective: To compare efficacy of tramadol and nalbuphine as potent analgesic in patients after PCNL. Study Design: A prospective randomized study. Settings: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad and Department of Urology, DHQ Hospital/Faisalabad Medical University, Faisalabad Pakistan. Duration: From September 2016 to September 2020 (4 Years). Methodology: 286 patients undergoing PCNL for either gender and sides enrolled in study according to inclusion and exclusion criteria. Patients divided into Group A (Administered with tramadol) and Group B (administered with nalbuphine) and patients evaluated for pain up to 48 hours after surgery using 11-point numerical pain rating scale rating from0-10 where 0 is no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain and 10 as worst pain and use of rescue analgesia observed in either groups. Data obtained and statistical evaluation done. Results: 286 patients enrolled from age 15-75 years with mean age of 40.2 years. Among 286 patients, 161 were male and 125 were female patients. Both groups A and B having 143 patients each. Analysis showed that tramadol has superiority over nalbuphine and need of analgesia is more in patient given nalbuphine (118 vs 31) as maintenance analgesic agent in post-operative period after PCNL. Conclusion: This study showed that tramadol has superiority over nalbuphine for analgesia after PCNL.

scholarly journals Efficacy of laparoscopic guided transversus abdominis plane block in post operative analgesia requirement in elective laparoscopic cholecystectomy

2021 ◽  
Vol 8 (3) ◽  
pp. 925
Author(s):  
Hanuman Ram Khoja ◽  
Dhanush Kumar Kunchagi ◽  
Praveen Kumar Joshi ◽  
Prabha Om
Keyword(s):  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Vas Score ◽  
Significant Difference ◽  
Analgesia Requirement ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Minimal invasive surgery has many advantages. In order to maintain and control  pain, one of the most effective technique is Transversus abdominis plane (TAP) block technique. Aim of the study was to demonstrate the efficacy of laparoscopic guided transversus abdominis plane block in post-operative analgesia requirement in elective laparoscopic cholecystectomy.Methods: It was a hospital based prospective interventional study. Sample size was calculated at 0.05 α error and 80% study power assuming mean difference of VAS score between TAP block +/A group  and TAP block- /B group is 1 and standard deviation of VAS score 1.3 among patients undergoing elective laparoscopic cholecystectomy.Results: A total of 60 patients were enrolled in this study. The mean age of group A was 48.56 years and for group B was 43.53 years. In group A 80% patients were females and for group B 83.3% patients were females. There was significant difference in VAS score at immediate post operation, at 1 hour, at 6 hours, at 18 hours and at 24 hours as p value was <0.0001 for all these groups. The mean VAS score was recorded less in group A at all the time duration compared to group B.Conclusions: With advantages like maximum safety, efficacy, potential for lower visceral injury risk and shorter operational time and other numerous advantages (decreased analgesic requirements, etc.)  laparoscopic-guided TAP block counts as an ideal abdominal field block in the patients.

Efficacy of Transversus Abdominis Plane Block After Post Caesarean Section Delivery

2018 ◽  
Vol 16 (1) ◽  
pp. 2-6
Author(s):  
Grisuna Singh ◽  
Farhat Banu ◽  
Husneyera Haque
Keyword(s):  
Caesarean Section ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
P Value ◽  
Transversus Abdominis Plane ◽  
Vas Score ◽  
Post Operative Pain ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Introduction: Post operative pain following caesarean section delivery can negatively affect early wound healing, proper breast feeding to the new born baby and therefore impair mother to child bonding. Combination of non steroidal anti inflammatory drugs (NSAIDS) and opioids has most commonly been used in pain management. The combination of regional anesthetic techniques like Transversus Abdominis Plane (TAP) block reduces pain and the dose of total analgesics consumed and therefore helps to prevent opioid related side effects. Objective: To evaluate the analgesic efficacy of Transversus Abdominis Plane block for management of postoperative pain in the first 24 hours after caesarean section. Methodology: It is a prospective randomized controlled single blinded study involving 60 patients of ASA II done in Nepalgunj Medical College Teaching Hospital over a period of 2 months. They are divided into two groups of 30 patients each. Group 1 received 20 ml of 0.25% isobaric bupivacaine in the triangle of Petit bilaterally. Group 2 received IV analgesics (NSAIDS and Tramadol 50 mg with Phenargan 25 mg). VAS score was taken every 6 hourly for 24 hours post operatively. Results: The mean VAS score of the patients in group 2 at 0-6 hours, 6-12 hours, 12-18 hours and 18-24 hours was 6.73(SD±0.69), 6.63(SD±0.610), 6.40(SD±0.56) and 6.43(SD±0.57) respectively. The mean VAS score of the patients who received block is significantly less as compared to those who did not receive the block with a p value of <0.001. The mean time to first analgesic request in group 1 was 10.83(SD±2.95) and in group 2 was 4.87(SD±0.68) with a p value of <0.001. In group 1, 70% patients received single dose of analgesics, 23.3% received two doses and 6.7% received three doses of analgesics. In group 2 all the patients received four doses of analgesics. Conclusion: Transversus Abdominis Plane Block can be used as a part of multimodal analgesic therapy for the management of post operative pain after caesarean section as it is technically less demanding, safe and economical. It reduces the side effects related with opioid analgesics and encourage early mobility, wound healing and proper mother to child bonding.

Tranversus Abdominus Plane Block with or without Magnesium Sulphate on Postoperative Pain Control after Open Appendectomy Operation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Menna A Elzyat ◽  
Nevine A Kaschef ◽  
Rania M Hussien ◽  
Simon H Armanios
Keyword(s):  
Magnesium Sulphate ◽  
Controlled Trial ◽  
Open Appendectomy ◽  
Transversus Abdominis ◽  
University Hospital ◽  
Tap Block ◽  
Rescue Dose ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Double Blinded

Abstract Background Patients undergoing Open Appendectomy experience pain postoperatively, requiring a multimodal approach to analgesia. The transversus abdominis plane (TAP) block seems to be an ideal approach. This block may be achieved using bupivacaine with adjuvants such as magnesium sulfate, which we were used in this study. Aim of the Work to detect the efficacy and safety of magnesium sulphate as an adjuvant to the analgesia offered by local anesthetic in ultrasound guided TAP block in patients undergoing open appendectomy. Patients and Methods A prospective double blinded randomized controlled trial was conducted on 60 patients undergoing open appendectomy at Ain Shams University Hospital, Cairo, Egypt. Results Our study concluded that co administration of 500mg MgSo4 to 0.5 % bupivacaine in US guided TAP block lead to: Significant decrease in VAS pain score especially at 4hrs, 6hrs and 12hrs,1st rescue dose of nalbuphine was delayed. And number of patients require rescue doses of nalbuphine in 1st 4 hrs, while only 2 patients require rescue doses of nalbuphine between 4&6 hrs.4 patients require rescue doses of nalbuphine between 6&12 hrs, while 26 patients require rescue doses of nalubuphine between 12&24hrs. we also cocluded that there were a significant decrease in HR and MABP especially at 4hrs and 6 hrs postoperative,. Conclusion MgSO4 as an adjuvant to bupivacaine in Ultra-sounded guided TAP block reduces post-operative pain scores, prolong the duration of analgesia and decreases demand for rescue analgesics.

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