scholarly journals The Safety and Efficacy of Ultrasound-Guided Bilateral Dual Transversus Abdominis Plane (BD-TAP) Block in ERAS Program of Laparoscopic Hepatectomy: A Prospective, Randomized, Controlled, Blinded, Clinical Study

2020 ◽  
Vol Volume 14 ◽  
pp. 2889-2898
Author(s):  
Jun Zhang ◽  
Tieshuai Liu ◽  
Haiyan Zhou ◽  
Yue Fei ◽  
Xin Yu
2019 ◽  
Vol 3 (1) ◽  
pp. 52
Author(s):  
I Wayan Budi Artana ◽  
Ida Ayu Manik Damayanti

Pendahuluan: Blok pada bidang transversus abdominis (transversus abdominis plane / TAP) merupakan teknik yang dilakukan dengan injeksi lokal anestesi secara bolus dengan dosis besar tunggal pada bidang transversus abdominis. Dalam penanganan nyeri pasca operasi seksio sesarea, Transversus Abdominis Plane (TAP) block, sebagai komponen regimen analgetik multimodal, memberikan analgesia yang paling baik diantara tehnik non-opioid. Metode: Penelitian ini menggunakan rancangan penelitian Randomized Controlled Trial (RCT). Kelompok A mendapat TAP blok bilateral dengan levobupivacaine 0,5% masing-masning 15 ml, dan kelompok B (kontrol) tidak mendapat TAP blok. Hasil: Penelitian ini menunjukkan bahwa derajat nyeri pada  kelompok blok TAP lebih rendah dibanding kelompok kontrol pada jam ke-4 sampai jam ke-12 pasca operasi. Penelitian ini memperlihatkan bahwa kebutuhan fentanil total selama 24 jam pasca bedah lebih sedikit pada kelompok yang mendapatkan blok TAP (54 +  43.10 μg) dibanding kelompok kontrol (95 +  43.30 μg). Perbedaan ini bermakna secara statistik (p<0,05).Diskusi: Pada penelitian ini diketahui TAP blok dengan panduan USG sebagai komponen analgesia multimodal, memberikan analgesia yang efektif dan mengurangi kebutuhan dosis obat anelgetik pasca operasi seksio sesarea.Kata Kunci : Transversus Abdominis Plane (TAP), analgetik, operasi sesarea


2021 ◽  
Vol 10 (3) ◽  
pp. 394
Author(s):  
Jannis Löchel ◽  
Viktor Janz ◽  
Vincent Justus Leopold ◽  
Michael Krämer ◽  
Georgi I. Wassilew

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.


QJM ◽  
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

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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