scholarly journals Ultrasound-Guided Lateral Transversus Abdominis Plane (TAP) Block in Rabbits: A Cadaveric Study

Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1953
Author(s):  
Caterina Di Bella ◽  
Luca Pennasilico ◽  
Francesco Staffieri ◽  
Federica Serino ◽  
Angela Palumbo Piccionello

The aims of the study were to describe the ultrasonographic-guided lateral TAP block in rabbit cadavers and evaluate the spread of a lidocaine/methylene blue solution through a single fascial infiltration. The US-guided block and anatomical dissections were performed in 17 New Zealand rabbit cadavers. The probe was placed perpendicular to the column, one centimetre ventrally to the transverse processes, halfway between the iliac crest and the costal margin. External oblique (EO), internal oblique (IO), and transversus abdominis (TA) muscles were visualised, and 1 mL/kg of lidocaine 2% plus methylene blue 1% was injected. After dissection, the branches of spinal nerves stained were measured. Moreover, the percentage of length and height of the area marked were calculated. A good visualisation of the TAP was obtained in all 34 hemiabdomens. T11 nerve eminence was successfully stained in 52% of cases. T12, L1, and L2 were stained in 75%, 95%, and 100% of cases, respectively. L3 and L4 were stained in 60% and 40% of cases, respectively. The lateral TAP block with a single point of injection can be easily performed in rabbits, but it is not sufficient to cover the nerve eminences of the cranial abdomen. The two-point TAP block (lateral and subcostal) could represent a better option, particularly when large surgical incisions are required.

2018 ◽  
Vol 8 (5) ◽  
pp. 37-41
Author(s):  
Minh Nguyen Van ◽  
Nga Bui Thi Thuy ◽  
Thinh Tran Xuan

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


2021 ◽  
pp. 1-7
Author(s):  
Iria Da Cuña-Carrera ◽  
Alejandra Alonso-Calvete ◽  
Yoana González-González ◽  
Mercedes Soto-González

BACKGROUND: The underlying morphology and behavior of abdominal muscles during breathing are still lacking in knowledge in healthy population. OBJECTIVE: To analyze the effects of three different types of breathing on the architectural characteristics of abdominal muscles. METHODS: Ninety-eight healthy subjects were measured to assess the effects of breathing on the abdominal muscles, subjects performed three different types of breathing and the muscular thickness was measured with ultrasound imaging, analyzing also the differences between sexes. RESULTS: During the three different types of breathing and in comparison with the resting state, an increase of the thickness has been reported in the transversus abdominis (p< 0.001; effect size = 2.44, very large) and internal oblique (p< 0.001; effect size = 1.04, moderate) in both sexes, but with a higher increase in men. External oblique and rectus abdominis increased their thickness through breathing only while the lips were with pursed (p< 0.05) with trivial effect sizes and only differences between sexes were found in rectus abdominis. CONCLUSIONS: All breathings activated the deepest abdominal muscles, but the most superficial were only activated with lips pursed. Moreover, men appeared to activate more the deepest abdominal muscles but also the rectus abdominis. Findings in this study support the use of different types of breathing depending on the muscle to be activated or the sex, helping health care professionals to address their interventions on the abdominal muscles with a more focused approach.


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.


2014 ◽  
Vol 608 ◽  
pp. 224-229 ◽  
Author(s):  
Potjanaporn Chaengchawi ◽  
Karn Serivalsatit ◽  
Pornapa Sujaridworakun

A visible-light responsive CdS/ZnO nanocomposite photocatalyst was successfully synthesized by precipitation of CdS nanoparticles, using Cd (NO3)2 and Na2S as starting materials, on ZnO nanoparticles and then calcined at 400°C for 2 hours. The effects of the mole ratio of CdS and ZnO in the composites on their phase, morphology, and surface area were investigated by X-ray Diffraction (XRD), scanning electron microscope (SEM), Brunauer Emmett Teller method (BET), respectively. The photocatalytic degradation of methylene blue solution in the presence of composite products under visible-light irradiation was investigated. The results showed that the mole ratio of CdS and ZnO played a significant role on photocatalytic performance. The highest photocatalytic activity was obtained from the CdS/ZnO nanocomposite with mole ratio of 1:4, which is higher than that of pure CdS and pure ZnO.


2021 ◽  
pp. bmjmilitary-2021-001827
Author(s):  
Scott Hughey ◽  
J Cole ◽  
G J Booth ◽  
R Gliniecki ◽  
E Stedjelarsen

IntroductionPlane blocks are an increasingly common type of regional anaesthesia technique in the perioperative period. Increased spread of local anaesthesia during plane blocks is thought to be related to an increased area of pain coverage. This study sought to assess differences in injectate spread comparing Tuohy needles with standard insulated stimulating block needles.Methods10 Yorkshire-Cross porcine cadavers were used in this study. Immediately following euthanasia, the cadavers underwent bilateral ultrasound-guided transversus abdominis plane (TAP) block injection with radiopaque contrast dye, with one side placed with a 20 g Tuohy needle, and the other side with a 20 g insulated stimulating block needle. Injectate spread was assessed using plain film X-ray and area of spread was measured to compare differences.ResultsAll 10 animals underwent successful ultrasound-guided TAP block placement. In all 10 animals, the area of contrast spread was greater with the Tuohy than stimulating needle. Wilcoxon signed-rank test was used to analyse the difference between the groups. The average difference between the two sides was 33.02% (p=0.002).ConclusionsThis is the first study to demonstrate differences in injectate spread with different needle types. This suggests enhanced spread with Tuohy needle compared with standard block needle, and may encourage its use during plane blocks.


2021 ◽  
Vol 4 (3) ◽  
pp. 01-05
Author(s):  
Ahmed Mamdouh

Background: The transverses abdominis plane block (TAP block) is one of the widely used regional analgesic techniques in cesarean section. There are different variations of the procedure. The aim of the present study was to evaluate the analgesic effect of the modified surgeon assisted bilateral TAP block in patients undergoing cesarean section Patients&Methods: Sixty patients undergoing cesarean section under spinal anesthesia were randomized into two groups to receive either TAP block with 40 ml of bupivacaine 0.25%(study group) or 40 ml normal saline as placebo after obtaining informed consent. All patients will receive intravenous diclofencac75mg every 12 hrs postoperatively. Postoperatively, there was an assessment every 2hrs during the first 24hrs by the visual analogue pain scale (VAPS). Time to the first analgesic request will be measured as primary outcome and all patients will receive opioid on demand or VAPS > 4 with 25mg pethidine intramuscularly. Moreover, total opioid requirement in 24hrs will be measured as secondary outcome along with postoperative complications as nausea, vomiting and abdominal distention. Complications related to the TAP procedure will be also assessed. Results: The median (interquartile range) time to the first analgesic request in the first 24hrs postoperatively was significantly shorter in the placebo group compared to the study group; 4h (4, 6) and 24h (10, 24) with p value < 0.001. Postoperative opioid requirement was significantly higher in the control group (30/30{100%}) than the study group (13/30{43.3%}). The median (interquartile range) number of opioid doses was significantly higher in the placebo group compared with the study group; 2(2, 2) and 0(0, 1) respectively. At all points in the study, pain scores both were lower in the study group (p < 0.0001). Conclusion: The modified surgeon assisted bilateral TAP block is relatively new, safe and cost effective technique which provides adequate postoperative analgesia allowing for better maternal ambulation and better postoperative recovery. Trial registration: Clinicaltrial.gov registration number: NCT04623632


2016 ◽  
Vol 27 (1) ◽  
pp. 3-11
Author(s):  
Bidhan Paul ◽  
Debashis Banik ◽  
AKM Shamsul Alam

Background: In perioperative care, a reliable pain management is a vital appeal. Over recent years, Transversus Abdominis Plane (TAP) block is introduced as an important component of multimodal analgesia.Objective: To evaluate efficacy of TAP block in postoperative analgesia for Total Abdominal Hysterectomy (TAH) with subarachnoid block (SAB) in comparison of morphine consumption and VAS score.Methods: 60 patients were randomly allocated into 2 groups (TAP group-A & control group-B). Standard SAB was applied to all patients for elective TAH. Immediate after operation classical TAP block was performed through both Lumber Triangle Of Petit (LTOP) of group A patients. Both groups were placed in Post Anesthesia Care Unit (PACU), arranged a common standard postoperative analgesic regimen for all, observed periodically and documented it accordingly in pre-designed data sheet.Results: TAP block prolonged the mean time of 1st required I/V morphine (TAP vs control, mean±SD 271.23±40.34 vs 195.33±22.16 min., p=0.001HS). Morphine requirement was also reduced (17.4±5.4 vs 26.2±4.4 mg, p=0.001HS). Pain VAS scores at rest and movement were also reduced at all time period (p? 0.01 to 0.001). There was no complication attributed to the TAP block.Conclusion: TAP block provided considerably effective postoperative analgesia in first 24 hours after major abdominal surgery like TAH.Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 3-11


2013 ◽  
Vol 668 ◽  
pp. 13-16
Author(s):  
Qing Shan Li ◽  
Biao Zhan ◽  
Wei Hong ◽  
Guang Zhong Xing

Opal as a carrier, tetrabutyl titanate as a titanium source, TiO2 loaded on opal was prepared by sol-gel technique. The photocatalysts were characterized by XRD, TEM and UV-VIS absorption spectrum. Their photocatalytic activities were examined by the photocatalytic decolorization of methylene blue solution under UV light irradiation. The effects of calcination temperature, the amount of TiO2 loading and pH on photocatalytic activities were discussed. The results show that TiO2 supported on opal induced enhancement of photocatalytic decolorization rant and TiO2 doping is about 30 wt. % with 92.15% of decolorization rate at 700°C.


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