scholarly journals Clinical analgesic efficacy of dexamethasone as a local anesthetic adjuvant for transversus abdominis plane (TAP) block: A meta-analysis

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198923 ◽  
Author(s):  
Qi Chen ◽  
Ran An ◽  
Ju Zhou ◽  
Bin Yang
Keyword(s):  
Local Anesthetic ◽  
Meta Analysis ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane

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

2019 ◽  
Vol 19 (1) ◽  
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 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.

scholarly journals Transversus Abdominis Plane Block versus Wound Infiltration with Conventional Local Anesthetics in Adult Patients Underwent Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-18 ◽  
Author(s):  
Qiang Cai ◽  
Mei-ling Gao ◽  
Guan-yu Chen ◽  
Ling-hui Pan
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Local Anesthetics ◽  
Meta Analysis ◽  
Adult Patients ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Wound Infiltration ◽  
Randomized Controlled

Background. How to effectively control the postoperative pain of patients is extremely important to clinicians. Transversus abdominis plane (TAP) block is a novel analgesic method reported to greatly decrease postoperative pain. However, in many areas, there still exists a phenomenon of surgeons using wound infiltration (WI) with conventional local anesthetics (not liposome anesthetics) as the main means to decrease postoperative pain because of traditional wisdom or convenience. Here, we compared the analgesic effectiveness of the two different methods to determine which method is more suitable for adult patients. Materials and methods. A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing TAP block and WI without liposome anesthetics in adult patients were performed. Frequently used databases were extensively searched. The main outcomes were postoperative pain scores in different situations (at rest or during movement) and the time until the first use of rescue analgesics. The secondary outcomes were postoperative nausea and vomiting (PONV) incidence and patient satisfaction scores. Results. Fifteen studies with 983 participants met the inclusion criteria and were included in the present study. The heterogeneity in the final analysis regarding the pain score was low to moderate. The major results of the sensitivity analysis were stable. WI had the same analgesic effect as TAP block only at the one-hour postoperative time point (mean difference=−0.32, 95% confidence interval (-0.87, 0.24), P=0.26) and was associated with a shorter time until the first rescue analgesic and poorer patient satisfaction. Conclusion. TAP block results in a more effective and steady analgesic effect than WI with conventional local anesthetics in adult patients from the early postoperative period and obtains higher patient satisfaction.

scholarly journals Transversus Abdominis Plane Block Appears to Be Effective and Safe as a Part of Multimodal Analgesia in Bariatric Surgery: a Meta-analysis and Systematic Review of Randomized Controlled Trials

2020 ◽  
Author(s):  
Mária Földi ◽  
Alexandra Soós ◽  
Péter Hegyi ◽  
Szabolcs Kiss ◽  
Zsolt Szakács ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Multimodal Analgesia ◽  
Transversus Abdominis ◽  
Controlled Trials ◽  
Laparoscopic Bariatric Surgery ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Randomized Controlled

Abstract Purpose Pain after bariatric surgery can prolong recovery. This patient group is highly susceptible to opioid-related side effects. Enhanced Recovery After Surgery guidelines strongly recommend the administration of multimodal medications to reduce narcotic consumption. However, the role of ultrasound-guided transversus abdominis plane (USG-TAP) block in multimodal analgesia of weight loss surgeries remains controversial. Materials and Methods A systematic search was performed in four databases for studies published up to September 2019. We considered randomized controlled trials that assessed the efficacy of perioperative USG-TAP block as a part of multimodal analgesia in patients with laparoscopic bariatric surgery. Results Eight studies (525 patients) were included in the meta-analysis. Pooled analysis showed lower pain scores with USG-TAP block at every evaluated time point and lower opioid requirement in the USG-TAP block group (weighted mean difference (WMD) = − 7.59 mg; 95% CI − 9.86, − 5.39; p < 0.001). Time to ambulate was shorter with USG-TAP block (WMD = − 2.22 h; 95% CI − 3.89, − 0.56; p = 0.009). This intervention also seemed to be safe: only three non-severe complications with USG-TAP block were reported in the included studies. Conclusion Our results may support the incorporation of USG-TAP block into multimodal analgesia regimens of ERAS protocols for bariatric surgery.

scholarly journals Transient Femoral Nerve Palsy Complicating “Blind” Transversus Abdominis Plane Block

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Dimitrios K. Manatakis ◽  
Nikolaos Stamos ◽  
Christos Agalianos ◽  
Michail Athanasios Karvelis ◽  
Michael Gkiaourakis ◽  
...  
Keyword(s):  
Local Anesthetic ◽  
Nerve Palsy ◽  
Ultrasound Guidance ◽  
Femoral Nerve ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversalis Fascia ◽  
Transversus Abdominis Plane ◽  
Femoral Nerve Palsy ◽  
A Minor

We present two cases of patients who reported quadriceps femoris weakness and hypoesthesia over the anterior thigh after an inguinal hernia repair under transversus abdominis plane (TAP) block. Transient femoral nerve palsy is the result of local anesthetic incorrectly injected between transversus abdominis muscle and transversalis fascia and pooling around the femoral nerve. Although it is a minor and self-limiting complication, it requires overnight hospital stay and observation of the patients. Performing the block under ultrasound guidance and injecting the least volume of local anesthetic required are ways of minimizing its incidence.

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

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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