Comparison of ultrasound guided transversus abdominis plane (TAP) block by posterior and lateral approach for their analgesic efficacy after lower abdominal surgery

2019 ◽  
Vol 10 (1) ◽  
pp. 22-27
Author(s):  
Shailendra Patil ◽  
◽  
Asmita Karnalkar ◽  
Kashinath Jadhav ◽  
◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Analgesic Efficacy ◽  
Lateral Approach ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided

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 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.

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 ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Renal Surgery ◽  
Postsurgical Pain

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 involving access through the lateral abdominal wall remains unknown. Therefore, 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 the intervention (T) or control (C) groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed preoperatively with 30 ml of 0.4% ropivacaine and an equivalent amount of normal saline in groups T and C, respectively. The primary outcomes were opioid consumption during surgery and in the first 24 h after surgery. Secondary outcomes were postsurgical pain intensity upon immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 h after surgery as well as recovery quality 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 and 51 in groups T and C, respectively. Laparoscopic surgery was converted to open surgery in one patient. Thus, he was excluded from the analysis. The median intraoperative and postoperative opioid consumption (oral morphine equivalent dose, o-MED) in the first 24 h after surgery were 105.0 and 32.5 mg in Group C, respectively, and the corresponding values in Group T were 121.0 and 39.7 mg, all of which were not significant (P = 0.284 and 0.311). Postsurgical pain intensity at all time points was comparable between the groups (all P > 0.05). Intergroup differences in the recovery quality variables were not significant (all P > 0.05). Conclusion Our findings demonstrated that preoperative lateral TAP could not decrease intraoperative or postoperative opioid consumption or pain intensity in the first 24 h after surgery, nor could it promote postoperative recovery in patients undergoing laparoscopic renal surgery through retroperitoneal access.

scholarly journals Analgesic efficacy of ultrasound-guided transversus abdominis plane block for laparoscopic gynecological surgery: a randomized controlled trial

2022 ◽  
Author(s):  
Divya Sethi ◽  
Garima Garg
Keyword(s):  
Postoperative Pain ◽  
Controlled Trial ◽  
Analgesic Efficacy ◽  
Port Site ◽  
Transversus Abdominis ◽  
Gynecological Surgery ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Significant Difference

Background: This study aimed to determine whether ultrasound-guided transversus abdominis plane (TAP) block is more effective in reducing postoperative pain and analgesic consumption than local anesthetic infiltration (LAI) at the port site for elective laparoscopic gynecological surgeries.Methods: Eighty patients with the American Society of Anesthesiologists status I/II undergoing laparoscopic gynecology surgery were enrolled for this randomized control trial. After general anesthesia was administered, patients in group C received LAI at each port site, and patients in group T received bilateral ultrasound-guided TAP. Postoperative pain was assessed at time intervals of 1/2, 2, 4, 6, 8, and 24 h using the numeric pain scale (NPS). Clinical metrics such as postoperative analgesic diclofenac consumption, need for rescue fentanyl, nausea-vomiting scores, and antiemetic requirements were also recorded.Results: Seventy-four patients were included in the final analysis. Postoperatively, patients in group T had significantly lower NPS than those in group C (P < 0.05). The highest difference in the postoperative NPS was observed at 2 h (median [1Q, 3Q]; group C = 3 [2, 4]; group T = 1 [0, 2]; P < 0.001). A statistically significant difference was observed in the frequency of diclofenac (75 mg intravenous) requirement between the groups (P = 0.010). No significant difference was observed between the groups in need of rescue fentanyl or antiemetic and the nausea-vomiting scores.Conclusions: In patients undergoing laparoscopic gynecological surgery, ultrasound-guided TAP block provided greater postoperative analgesic benefits in terms of lower NPS and reduced analgesic requirements than port site LAI.

scholarly journals Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block after Cesarean Delivery

2021 ◽  
Vol 4 (1) ◽  
pp. 27-32
Author(s):  
Archana Yadav ◽  
Amir Babu Shrestha ◽  
Tara Gurung ◽  
Sangita Shrestha
Keyword(s):  
Cesarean Delivery ◽  
Rating Scale ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Pain Rating ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Numerical Pain Rating Scale ◽  
Pain Rating Scale

Introduction Transversus abdominis plane (TAP) block is a simple and effective technique of providing analgesia for lower abdominal surgeries with easily identifiable landmarks. This study investigated the postoperative analgesic efficacy of bilateral ultrasound-guided transversus abdominis plane blocks, in patients undergoing caesarean delivery at Paropakar Maternity and Women's Hospital, Kathmandu, Nepal. Methods Seventy-four patients undergoing caesarean section under spinal anesthesia were randomized to receive TAP block with bupivacaine (n =37) versus no TAP group (n =37), in addition to analgesia with intravenous paracetamol 1gram 6 hourly. At the end of the surgery, an ultrasound-guided TAP block was given bilaterally using 0.25% bupivacaine or no TAP block. Each patient was assessed postoperatively at regular intervals up to 24 hours for numerical pain rating scale and requirement of pethidine. SPSS version 20.0 software was used. Demographic data were analyzed using Student’s t-test and Mann–Whitney U-test. Results The TAP block with bupivacaine compared with no TAP group reduced the postoperative numerical pain rating scale. The time to first analgesic demand time was shorter in the control group (79.05±26.99) minutes compared to the bupivacaine group (416.75±87.29) minutes (P <0.05) which was statically significant. The 24 hours pethidine requirement was less in the bupivacaine group (P<0.05). There were no complications attributable to the TAP block. Conclusions Bilateral ultrasound-guided TAP block significantly reduced postoperative pethidine consumption in 24 hours after cesarean delivery.

scholarly journals Analgesic and Respiratory Effects of Two Doses of Morphine as an Adjunct to Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block in Upper Abdominal Surgery

2019 ◽  
Vol 5 (22;5) ◽  
pp. 509-517
Author(s):  
Hala S. Abdel-Ghaffar
Keyword(s):  
Abdominal Surgery ◽  
Single Injection ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Morphine Group ◽  
Significant Difference ◽  
Group B ◽  
Upper Abdominal

Background: Opioid receptors are present at the terminals of afferent peripheral nerves; therefore, administration of opioids peripherally might provide a significant analgesic effect. Objectives: We investigated the analgesic efficacy of 2 different doses of morphine in bilateral subcostal single-injection ultrasound-guided transversus abdominis plane (TAP) block in abdominal surgery. Study Design: Randomized, controlled, double-blind trial. Setting: University hospital. Methods: We enrolled 90 patients (aged 18-60 years) who were scheduled for elective upper abdominal surgeries and received TAP block for postoperative analgesia. Patients received 20 mL bupivacaine 0.5% (group B) only or combined with 10 mg morphine (group BM10) or 15 mg morphine (group BM15). Study drugs were diluted with saline solution 0.9% to 40 mL volume and bupivacaine concentration of 0.25% and injected 20 mL on each side. Primary outcome was the verbal rating pain scale (VRS) over the first 24 hours postoperatively. Secondary outcomes were time to first request for analgesics, total analgesic consumption, lung spirometry, and adverse effects. Results: Compared with group B, patients in BM10 and BM15 groups showed significantly lower postoperative VRS scores at rest and during cough. Patients in BM15 group had lower VRS scores at the 24th hour postoperatively at rest (P = 0.034) and during cough (P = 0.040), compared with group BM10, with no significant difference at other timepoints. The median time to first request for intravenous patient controlled analgesia (PCA) nalbuphine was 10 hours (range, 6-12 hours) in group B versus 15 hours (8-18 hours; P = 0.000) and 16 hours (10-23 hours; P = 0.000) in BM10 and BM15 groups, respectively. Total consumption of nalbuphine PCA in BM15 group was 12 mg (6-18 mg) compared with 26 mg (20-34 mg; P = 0.000) and 18 mg (12-24 mg; P = 0.000] in groups B and BM10, respectively, with a significant difference between BM10 and BM15 groups (P = 0.000) and without significant adverse effects. Limitations: A limitation was a small sample size. Conclusions: Addition of morphine to bupivacaine in single-injection subcostal TAP block controlled pain and reduced opioid requirements after abdominal surgery in a dose–dependent manner. Key words: Abdominal surgery, analgesia, transversus abdominis plane block, morphine

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.

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 ◽  
Zengmao Lin
Keyword(s):  
Pain Intensity ◽  
Abdominal Wall ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Renal Surgery ◽  
Postsurgical Pain

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether it is useful in renal surgery involving access through the lateral abdominal wall remains unknown. Therefore, the study was aimed at evaluating 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 the intervention (T) and control (C) groups. After anesthesia induction, ultrasound-guided lateral TAP block was performed preoperatively with 30 mL of 0.4% ropivacaine and an equivalent amount of normal saline in groups T and C, respectively. The primary outcomes were opioid consumption during surgery and in the first 24 h after surgery. Secondary outcomes were postsurgical pain intensity at immediately awakening from anesthesia, and 0.5, 1, 2, 6, 12, 24 h after surgery, and recovery quality variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage in the first 24 h after surgery, and length of hospital stay. Results 104 patients were enrolled and randomized: 53 and 51 in groups T and C, respectively. The median intraoperative sufentanil and remifentanil and postoperative sufentanil consumption per kilogram in the first 24 h after surgery was 0.33, 9.02, and 0.57 μg in Group T, respectively; the corresponding values in Group C were 0.30, 9.58, and 0.48 μg, all of which were not significant (p = 0.528, 0.903, and 0.244). Postsurgical pain intensity at all time points was comparable between the groups (all p > 0.05). Intergroup differences in recovery quality variables were not significant (all p > 0.05). Conclusion Our findings demonstrated that preoperative lateral TAP could not decrease intraoperative and postoperative opioid consumption and pain intensity in the first 24 h after surgery, nor could it promote postoperative recovery in patients undergoing laparoscopic renal surgery through retroperitoneal access.

scholarly journals Transversus Abdominis Plane (TAP) Block: A Comparative Study between Levobupivacaine versus Levobupivacaine plus Ketamine in Abdominoplasty

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Radwa F. Mansour ◽  
Mohamed A. Afifi ◽  
Mohamed S. Abdelghany
Keyword(s):  
Visual Analogue Scale ◽  
Prospective Study ◽  
Analogue Scale ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Prolonged Duration

Purpose. We conducted this study to explore the hypothesis that the addition of ketamine to levobupivacaine in ultrasound-guided Transversus Abdominis Plane (TAP) block would result in a better and prolonged duration of postoperative analgesia for patients undergoing abdominoplasty. Material and Methods. This randomized prospective study was conducted on 50 patients who were scheduled for abdominoplasty. TAP block was performed bilaterally for all patients either with levobupivacaine 0.5% 15 ml plus ketamine 0.5 mg/kg in a total volume of 20 ml in the LK group (n = 25) or with levobupivacaine 0.5% 15 ml plus 5 ml normal saline in a total volume of 20 ml in the L group on each side. Results. Visual analogue scale (VAS) was significantly lower in the LK group in resting condition at 6, 12, and 16 h postoperatively compared to the L group. On movement, the VAS was significantly lower at 4, 6, 8, 12, 16, and 24 h postoperatively in the LK group compared to the L group. The time for first rescue analgesia was longer in the LK group (18.7 ± 4.8 h) than that in the L group (6.5 ± 2.4 h) with the reduced total amount of rescue morphine in the LK group (1.14 ± 2.2 mg) versus the L group (5.86 ± 3.6 mg). Only six patients in the LK group requested rescue morphine, whereas nineteen patients requested rescue morphine in the L group. Conclusions. In TAP block, adding ketamine 0.5 mg/kg enhanced the analgesic efficacy of levobupivacaine 0.5% in patients undergoing abdominoplasty and reduced the required analgesics postoperatively.

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