Combination of Transversus abdominis plane block and Serratus plane block anesthesia in dogs submitted to masctetomy

ABSTRACT: This paper pretends to demonstrate the effect of the combination of transversus abdominis plane block (TAP block) and Serratus plane block (SP block) techniques in analgesia of 4 dogs undergoing total unilateral mastectomy. Dogs were premedicated with methadone (0.5mg.kg-1) intramuscularly. Anesthesia was induced with propofol (6mg.kg-1) and midazolam (0.3mg.kg-1) and maintained with isoflurane. SP and TAP block were performed unilaterally using ultrasound by the injection of bupivacaine 0.25% (0.3mL kg-1) diluted with NaCl solution 1:1. Heart rate (HR), respiratory rate (f), non-invasive arterial pressure, esophageal temperature (T), oxygen saturation (SpO2) and electrocardiogram were monitored continuously. Animals were monitored for two and four hours after extubation for pain by using the Canine Acute Pain Scale from Colorado State University. Two hours after extubation, tramadol (4mg.kg-1) and dipyrone (25mg.kg-1) was administered to all dogs. It was not observed any alteration on cardiac rhythm. HR, f, T and mean arterial pressure remained below the preincisional values for all dogs. No dog required intraoperative rescue analgesia. Recovery from anesthesia was without any complication. All animals scored 0 (0/5) at pain scale, two and four hours after extubation and none of them expressed concern over the surgical wound. Dogs were able to walk before two hours after extubation. The combination of both techniques is effective in anesthetic blocking the thoracic and abdominal walls and it is suggested both may be included in the multimodal analgesia protocols for this type of surgery.

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A comparison of transversus abdominis plane block with quadratus lumborum block for post-operative analgesia in abdominal hysterectomy: a retrospective observational study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211444 ◽

2021 ◽

Author(s):

Sumit Kumar Gupta ◽

Ritu Grewal ◽

Sirisha Anne ◽

Arpit Garg

Keyword(s):

Observational Study ◽

Abdominal Hysterectomy ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Retrospective Observational Study ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum

Background: Abdominal hysterectomy is the most common surgery performed in Indian Women. Recent advances in Regional Anaesthesia especially ultrasonography-guided truncal blocks for postoperative analgesia are now being used for patient comfort and faster times for discharge of the patients. This study compares the ultrasonographic guided transversus abdominis plane block and quadratus lumborum blocks for patients undergoing abdominal hysterectomy under general anaesthesia. Aim of the study was to compare the efficacy of transversus abdominis plane block and quadratus lumborum blocks in patients undergoing abdominal hysterectomy.Methods: A retrospective observational study of prospectively collected data was performed. A total of 111 patients of American Society of Anesthesiologists (ASA) II and III gradings were enrolled in the study who had received either transversus abdominis plane block or quadratus lumborum blocks. Visual analog scale (VAS) scores and use of rescue analgesia was studied between the two groups. The data obtained were analysed using the students t-test and Mann Whitney U Test.Results: The demographic profile was similar between the 2 groups. The study showed that patients who received the quadratus lumborum block had a greater analgesia after 6 hours and had lower analgesic requirements compared to those who received transversus abdominis block (TAP) block. TAP block was however effective in the initial post-operative period.Conclusions: In patients undergoing abdominal hysterectomy quadratus lumborum block may be preferred over TAP block for post-operative analgesia.

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A Comparative Study Between Magnesium Sulfate Versus Morphine Added to Bupivacaine in Ultra-Sound Guided Transversus Abdominis Plane Block for Post-Operative Analgesia after Inguinal Herniorraphy

QJM ◽

10.1093/qjmed/hcaa039.045 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A M Kamaly ◽

A M Khamies ◽

R M Hassan ◽

H A H Tawfik

Keyword(s):

Inguinal Hernia ◽

Magnesium Sulfate ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Ultra Sound ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Group I ◽

Inguinal Herniorraphy

Abstract Background Inguinal hernia considered the third common disease in surgeries for adult 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. A significant proportion of pain experienced by patients undergoing abdominal surgeries is related to somatic pain signals derived from the abdominal wall. Aim of the Work The aim of this study is to assess the postoperative analgesic efficacy of Magnesium sulfate added to Bupivacine verus Morphine to Bupivacaine in ultrasound guided transversus abdominis plane (TAP) block after inguinal herniorraphy regarding the pain relief and the amount of rescue analgesia used postoperative. Patients and Methods The study was conducted on 45 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in three groups of 15 patients each: Group - I (B): received TAP block with Bupivacaine only as a “Control Group”. Group - II (B-MO): received TAP Block with Bupivacaine plus Morphine. Group - III (B-Mg): received TAP block with Bupivacaine plus Magnesium Sulfate. The three groups were adequately monitored and assessed intra- and post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia and total consumption of it in the 1st 24 postoperative hours. Demographic data and post-operative hemodynamics were also assessed. Results The results of the study revealed that Magnesium added to bupivacaine better than Morphine added to Bupivacaine in transversus abdominis plane block regarding the postoperative analgesia after inguinal Herniorraphy. Conclusion In Conclusion the addition of MgSo4 as an adjuvant to bupivacaine in TAP block has shown superiority over either mono-therapy with bupivacaine or bupivacaine-Morphine combination in many aspects such as postoperative analgesic outcome assessed by VAS score, 1st time of rescue analgesia and without the pronounced side effects of the conventional postoperative opioids and less side effect than Morphine.

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Eﬃcacy of Double Pop Blind TAP Block – Double-Blinded Randomized Controlled Study

Asian Journal of Medical Research ◽

10.47009/ajmr.2020.9.2.an1 ◽

2020 ◽

Vol 9 (2) ◽

pp. 1-3

Author(s):

Simon Richard ◽

Sharad Goel ◽

Akhilesh Mishra ◽

S. Ali Imam ◽

Samir El Said ◽

...

Keyword(s):

Perioperative Period ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Controlled Study ◽

Control Group ◽

P Value ◽

Study Group ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia

Background: The transversus abdominis plane block (TAP block) in the petit triangle is being used since 2001 for analgesia by blocking the T6 to T12 nerves, which is devoid of the sympathetic blockade and has opioid-sparing effect during and after abdominal operations. The appropriateness and efficacy of using double pop blind transversus abdominis plane block were studied in abdominal surgeries using bupivacaine with butorphanol as additive. Subjects and Methods: A total of 78 adult patients of ASA I and II were included, who were to undergo laparoscopic cholecystectomy under general anesthesia. The control group patients received tramadol, diclofenac, and paracetamol in the perioperative period. The study group patients received TAP block by double pop blind technique after induction of anesthesia but before surgical incision as preemptive analgesia. The p-value, the mean and the confidence interval were calculated by using Student t-test with the use of online software by graphpad.com. Results: Each of the two groups had 39 patients, and none met the exclusion criteria. Patients of the study (TAP) group remained pain-free for a longer time by 439 (416 – 463) minutes more than the control (IV, Intravenous) group. Rescue analgesia in the study group was required 640 minutes after the end of the surgery, but in the control group, rescue analgesia was required earlier at 200 minutes only after the surgery. Conclusion: Double pop blind technique for TAP block is appropriate and without complications if done with carefulness as to avoid penetration of the blunted green needle beyond the fascia between the internal oblique and the transversus abdominis muscle.

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EFFICACY OF TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POST CESAREAN DELIVERY ANALGESIA

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.5.5 ◽

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

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Efficacy of transversus abdominis plane block in pain control after general abdominal surgery – a short review of the literature

Acta Marisiensis - Seria Medica ◽

10.2478/amma-2021-0028 ◽

2021 ◽

Vol 67 (3) ◽

pp. 137-142

Author(s):

Mihaela Butiulca ◽

Alexandra Lazăr

Keyword(s):

Abdominal Surgery ◽

Analgesic Efficacy ◽

Short Review ◽

Multimodal Analgesia ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Review Of The Literature ◽

Transversus Abdominis Plane ◽

Reduction Of Pain ◽

Secondary Outcomes

Abstract Objective: The aim of the study is the assessment of the analgesic efficacy of transversus abdominis plane block in patients undergoing general abdominal surgery. Methods: Pubmed, Scopus, and Medline databases were searched for papers evaluating the effect of transversus abdominis plane block. The primary and secondary outcomes of the studies were analyzed. Results: A total of 10 studies were analyzed, including 717 patients. Studies revealed that transversus abdominis plane block was associated with significantly reduced postoperative discomfort and reduced opioid consumption. Conclusion: The present study shows the clear benefit brought by the transversus abdominis plane block as part of multimodal analgesia, with a significant reduction of pain and higher comfort scores.

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Efficacy of Transversus Abdominis Plane (TAP) Block as Part of Multimodal Analgesia after Cesarean Section Delivery

Journal of Anesthesia & Critical Care Open Access ◽

10.15406/jaccoa.2015.03.00100 ◽

2015 ◽

Vol 3 (3) ◽

Cited By ~ 1

Author(s):

Fentahun Tarekegn

Keyword(s):

Cesarean Section ◽

Multimodal Analgesia ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Cesarean Section Delivery

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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 ◽

10.1093/qjmed/hcab086.106 ◽

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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Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

Birat Journal of Health Sciences ◽

10.3126/bjhs.v4i2.25460 ◽

2019 ◽

Vol 4 (2) ◽

pp. 755-758

Author(s):

Roshan Pradhan ◽

Seema Kumari Mishra ◽

Lalit Kumar Rajbanshi ◽

Kanak Khanal ◽

Batsalya Arjyal ◽

...

Keyword(s):

Caesarean Section ◽

Pain Score ◽

Postoperative Analgesia ◽

Transversus Abdominis ◽

Control Group ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Visual Analogue Pain ◽

Significant Difference

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption. Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section. Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively. Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points. Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

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A prospective study of efficacy of ultrasound guided transversus abdominis plane block for postcesarean analgesia

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20191949 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1951

Author(s):

Sravani Manam ◽

R. N. V. Swetha ◽

A. S. Kameswara Rao ◽

S. G. K. Murthy

Keyword(s):

Total Dose ◽

Postoperative Period ◽

Transversus Abdominis ◽

Control Group ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Rescue Analgesia ◽

Significant Difference ◽

Group B

Background: The ultrasound guided transversus abdominis plane (TAP) block which provides effective analgesia after lower abdominal surgeries including caesarean section. It is a simple and reliable technique. In this prospective, randomized double-blind study, we determined the efficacy of TAP block using 0.25% Bupivacaine and 0.9N Saline with respect to VAS for pain, postoperative Tramadol consumption and post-operative ondansetron usage.Methods: This study was conducted on 100 adult patients of ASA physical status I and II in the age group of 18 to 40 years undergoing elective lower segment cesarean section under spinal anaesthesia. Study group received TAP block with 0.25% Bupivacaine and control group received 10 ml of 0.9N saline on each side. Patients were analyzed for postoperative pain by pain score (at rest, on movement, on cough) using VAS was recorded at 0, ½, 1, 2, 4, 6, 12 and 24 hours postoperatively. Need for rescue analgesia was assessed by time to first dose of Tramadol requirement and total dose of Tramadol over 24 hours of postoperative period. Ondansetron (4 mg i.v.) was administered whenever nausea score was more than 2 or the patient vomited. All the data was noted using uniform performs.Results: Patients received TAP block with 0.25% Bupivacaine had better pain scores at first hour of postoperative period during rest, cough and movement which was statistically significant (p<0.0010) in comparison to group B. There was a statistically significant difference (p <0.001) in the requirement of total dose of Tramadol as a rescue analgesia in patients who received transversus abdominis block with 0.25% Bupivacaine (138.77 mg) in comparison with other group(240 mg).The mean time to first request for Tramadol was significantly longer in group A (5.8 hrs) in comparison to group B (1.93 hrs) with p value <0.001. Patients received TAP block with 0.9N saline needed more dose of Ondansetron, however, the difference was not statistically significant (p >0.001).Conclusions: TAP block using ultrasound provides substantial reduction in Tramadol consumption, time to first dose of rescue tramadol when compared with control group. This study reinforces the recommendation for TAP as a part of multimodal post-operative analgesic regimen.

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