scholarly journals Combined Subcostal and Posterior Transversus Abdominis Plane Block for Postoperative Pain Relief after Abdominoplasty: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Haytham El Sayed ◽  
A Shaheed Fadhul ◽  
Mohamed Al Falaki ◽  
M Nasr Awad
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Control Group ◽  
Transversus Abdominis Plane ◽  
Esthetic Surgery ◽  
Analgesic Regimen ◽  
Vas Scores ◽  
And Control

Abstract Background: Abdominoplasty is a common esthetic surgery for adequate pain management during the postoperative period. Transversus abdominis plane block (TAPB) is a therapeutic complement for analgesia for postoperative pain following abdominal surgery.Aim: To compare the outcomes of TAPB and systemic opioids in patients undergoing abdominoplasty.Methods: Fifty-eight patients undergoing abdominoplasty were randomly assigned to two groups: Combined subcostal and posterior TAPB group (BG, n=29) and Control group (CG, n=29). The standard postoperative analgesic regimen for both groups consisted of IV Paracetamol 1 g every 6 h. The visual analog scale (VAS) scores for pain were recorded postoperatively, and once the patient had a VAS ≥4, IV pethidine was administered. The primary outcome was pethidine consumption in the first 72 h postoperatively; the secondary outcomes included VAS scores at rest and during movement in the first 72 h postoperatively, time to first ambulation, and time to first incentive spirometer at 900 mL/min.Results: Pethidine consumption in the first 72 h was 208.62±85.64 in the CG group and 20.69±25.06 in BG (p<0.05). VAS was lower in BG during the first 72 h both at rest and during movement (p<0.05). Time to first ambulation was 12.41±5.04 h in the CG group and 4.62±1.08 h in BG (p<0.05), time to first incentive spirometer at 900 mL/min was 11.45±5.05 h in CG and 4.27±1.09 h in BG (p<0.05).Conclusion: Combined subcostal and posterior TAPB offers a longer postoperative analgesic effect and reduced postoperative opioid requirements with fewer postoperative complications.Trial RegistrationClinical Trial: TCTR20200602001 “Retrospectively registered”Date of registration on May 30, 2020.

scholarly journals Combined subcostal and posterior transversus abdominis plane block for postoperative pain relief after abdominoplasty

2021 ◽  
Author(s):  
Haytham El Sayed ◽  
A Shaheed Fadhul ◽  
Mohamed Al Falalki ◽  
M Nasr Awad
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Aesthetic Surgery ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Postoperative Pain Relief ◽  
Secondary Outcome ◽  
Anesthetic Technique ◽  
Transversus Abdominis Plane ◽  
Analgesic Regimen

Abstract Background: Abdominoplasty is a common aesthetic surgery. Adequate pain management during the postoperative period is of great importance. This research aims to investigate the outcome of the abdominoplasty operation for the patients who have received transversus abdominis plan block in comparison with the non-blocked patients.Methods: 58 patients, undergoing elective abdominoplasty, patients were randomly assigned to two equal groups of 29 patients each. Combined subcostal and posterior transversus abdominis plane block group and non-blocked group. For both groups, the standard postoperative analgesic regimen consisted of IV Paracetamol 1 g every 6 hours. Values of visual analog scale (VAS) were recorded postoperatively, once the patient had a VAS ≥ 4, IV opioids administered. The primary outcome was opioids consumption in the first 72 hours postoperatively, the secondary outcome was the value of VAS at rest and movement (or with knee flexion) in the first 72 hours postoperatively, time to first ambulation and time to first incentive spirometer 900 ml/min were recorded.Results: Pethidine consumption in the first 72 hours was 208.62±85.64 in the non-blocked group and 20.69±25.06 in the blocked group (p < 0.05). VAS was lower in the blocked group during the first 72 hours either during rest or movement where (p < 0.05). Time to first ambulation was 12.41±5.04 hours in the non-blocked group and 4.62±1.08 hours in the blocked group (p < 0.05), time to first incentive spirometer 900 ml/min was 11.45±5.05 hours in the non-blocked group and 4.27±1.09 hours in the blocked group (p < 0.05).Conclusion: Combined subcostal and posterior transversus abdominis plane block is a promising regional anesthetic technique for postoperative pain relief in abdominoplasty surgery, it offers a longer postoperative analgesic effect duration and fewer analgesic requirements with less postoperative complications.Trial Registration Clinical Trial: TCTR20200602001 “Retrospectively registered” Date of registration on May 30, 2020

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.

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