scholarly journals Efektivitas Blok Transversus Abdominis Plane Pasca Operasi Caesar

2020 ◽  
Vol 3 (1) ◽  
pp. 59-71
Author(s):  
Gusti muhammad Fuad Suharto ◽  
Rory Denny Saputra
Keyword(s):  
Postoperative Pain ◽  
Caesarean Section ◽  
Abdominal Wall ◽  
Newborn Care ◽  
Nerve Fibers ◽  
Transversus Abdominis ◽  
Anesthetic Technique ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Caesarean Section Delivery

Operasi caesar merupakan prosedur bedah yang paling umum dilakukan di seluruh dunia. Operasi ini menyebabkan nyeri pasca operatif sedang hingga berat sebagai akibat insisi pfannenstiel yang umumnya dikaitkan dengan rasa nyeri pada uterus dan somatik pada dinding abdomen. Analgesia pasca operasi yang memadai pada pasien obstetrik sangat penting karena mereka memiliki kebutuhan pemulihan bedah yang berbeda, yaitu meliputi menyusui dan perawatan bayi baru lahir, hal ini dapat terganggu jika analgesia yang diberikan tidak memuaskan. Rejimen analgesik pasca operasi yang ideal harus efektif tanpa mempengaruhi ibu untuk merawat neonates dan dengan efek transfer obat yang seminimal mungkin melalui ASI. Saat ini banyak cara yang paling aman dan efektif dari intervensi manajemen nyeri pasca operasi seperti anestesi lokal dengan infiltrasi kulit, analgesia epidural, dan blok bidang seperti blok transversus abdominis plane (TAP) dan blok ilioinguinal-iliohipogastrik (II-IH). Blok TAP merupakan teknik anestesi regional dimana serabut saraf aferen yang menginervasi dinding abdomen bagian anterolateral diblokir dengan mengguakan anestesi lokal di bidang transversus abdominalis. Potensinya dalam meningkatkan kualitas dan durasi analgesia setelah berbagai operasi abdomen bawah sudah tidak bisa dipungkiri lagi. Sekarang, dengan bantuan USG menjadikan blok TAP sebagai metode yang aman dan efektif untuk memberikan analgesia pasca operasi caesar dibandingkan dengan perawatan standar pasca operasi. Selain itu, blok TAP juga dikaitkan dengan pengurangan konsumsi opioid, peningkatan kepuasan pasien, dan efektif untuk mengurangi nyeri dibandingkan dengan teknik analgesia lainnya. Efficacy of Transversus Abdominis Plane Block After Post Caesarean Section Delivery Abstract Caesarean section is the most common surgical procedure performed worldwide. This operation causes moderate to severe postoperative pain as a result of pfannenstiel incision which is commonly associated with pain in the uterus and somatic in the abdominal wall. Adequate postoperative analgesia in obstetric patients is very important because they have different surgical recovery needs, which include breastfeeding and newborn care, this is can be disrupted if the analgesia given is not satisfactory. The ideal postoperative analgesic rejimen must be effective without affecting the mother to treat the neonate and with minimal effect of drug transfer through breast milk. There are currently many of the safest and effective ways of interventions for postoperative pain management such as local anesthetic skin infiltration, epidural analgesia, and field block like TAP and II-IH. TAP block is a regional anesthetic technique where afferent nerve fibers that innervate the anterolateral abdominal wall are blocked by using local anesthesia in the transverse abdominal plane area. Potential in improving the quality and duration of analgesia after various lower abdominal operations is inevitable. Now, with ultrasound guiding, the TAP block is a safe and effective method for providing analgesia post caesarean section delivery compared to standard postoperative care. In addition, TAP block is also associated with a reduction of opioid consumption, increased patient satisfaction, and is effective in reducing pain compared to other analgesia technique.

scholarly journals Combined caudal retrocostal and lateral ultrasound-guided approach for transversus abdominis plane injection: A descriptive pilot study in pig cadavers

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248131
Author(s):  
Ivana Calice ◽  
Silvio Kau ◽  
Christian Knecht ◽  
Pablo E. Otero ◽  
M. Paula Larenza Menzies
Keyword(s):  
Abdominal Wall ◽  
Iliac Crest ◽  
Lateral Approach ◽  
Transversus Abdominis ◽  
Anesthetic Technique ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Injection Point ◽  
Costal Arch ◽  
Regional Anesthetic

Transversus abdominis plane (TAP) block is a regional anesthetic technique used to desensitize the abdominal wall in several species. This study aimed to describe the anatomical characteristics of the abdominal wall and to identify a feasible approach for an US-guided TAP injection that would result in adequate staining of the relevant nerves in the abdominal wall in pig cadavers. Fresh cadavers from five Landrace pigs (age, 12 weeks; body weight, 35.5 ± 1.6 kg) were used. One pig (n = 1) was anatomically dissected, and four pigs (n = 4; i.e., 8 hemiabdomens) were used for TAP injections and evaluation of dye spread. The volume of 0.3 mL/kg/injection point of methylene blue was injected bilaterally. In the caudal retrocostal approach, the injection was performed ventral to the most caudal part of the costal arch. In the lateral approach, the injection was performed between the last rib and iliac crest. A needle was inserted in plane for the caudal retrocostal and the lateral approach caudocranially and craniocaudally, respectively. Successful staining was defined as presence of dye on the nerve for a length of >1 cm in its entire circumference. The TAP was found between different muscle layers in the described anatomical regions. In the caudal retrocostal approach the TAP was found between the external abdominal oblique and transversus abdominis muscle bellies. In the lateral approach the TAP was found between the internal abdominal oblique and transversus abdominis muscles. The approach combining lateral and caudal retrocostal injections at the studied volume stained a median of 5 (3–6) target nerves from the fourth-last thoracic nerve to L2 (six nerves). Combined caudal retrocostal and lateral TAP injections of 0.3 mL/kg/injection point, resulted in staining of target nerve branches which supply the periumbilical and caudal abdominal wall in pig cadavers.

scholarly journals Assessment of Transversus Abdominis Plane Block in Abdominal Surgery by Total Requirement of Diclofenac as a Post-Operative Analgesia Drug

2020 ◽  
Vol 5 (1) ◽  
pp. 41-46
Author(s):  
Jigna R Shah ◽  
Apoorva Moghe ◽  
Maulik Humbal
Keyword(s):  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Abdominal Wall ◽  
Surgical Procedures ◽  
Transversus Abdominis ◽  
Control Group ◽  
Study Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia

Background: Amongst various techniques of TAP block, landmark technique via the triangle of Petit seems to hold considerable promise for patients undergoing surgical procedures involving abdominal wall incisions. The aim of this study is to evaluate transversus abdominis plane [TAP] block in abdominal surgery by total requirement of diclofenac as postoperative analgesia drug.Subjects and Methods:Present study was carried out at Department of Anesthesia, GMERS medical college, Sola, Ahmedabad, Gujarat, India from May 2014 to May 2015. According to formula based nomogram, sample size for proposed study would be: Study group (n=30): patient received TAP block with injection bupivacaine (0.25%) 20 ml. Control group (n=30): patient not received TAP block and was given injection diclofenac on demand for post-operative analgesia as per institute protocol for routine surgery. Sensory block was assessed by sterile pin prick method in the midaxillary line on both sides of chest. Postoperative pain was assessed by using the visual analogue scale.Results:Majority of the patient were in age group of 30 to 50 in both group. VAS score was significantly higher in control group as compared to the study group at all the time. First dose of rescue analgesia required in study group was at 669.66± 346 min and in control group was 220.33 ± 139.24 min which was statistically significant. Diclofenac requirement in study group was one time in 22 patient and two time in 8 patient which was significantly less as compare to control group in which diclofenac requirement was one time in 2 patient and two time in 5 patient and three time in 23 patient in 24 hour.Conclusion:TAP block is a promising new technique for postoperative pain management in surgery involving the anterior abdominal wall as a part of multimodal analgesia. Further studies are warranted to support this finding before establishing it in routine clinical practice in different type of surgical procedures.

EFFICACY OF TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POST CESAREAN DELIVERY ANALGESIA

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

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.

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

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.

scholarly journals Transversus Abdominis Plane Block versus Wound Infiltration with Conventional Local Anesthetics in Adult Patients Underwent Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-18 ◽  
Author(s):  
Qiang Cai ◽  
Mei-ling Gao ◽  
Guan-yu Chen ◽  
Ling-hui Pan
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Local Anesthetics ◽  
Meta Analysis ◽  
Adult Patients ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Wound Infiltration ◽  
Randomized Controlled

Background. How to effectively control the postoperative pain of patients is extremely important to clinicians. Transversus abdominis plane (TAP) block is a novel analgesic method reported to greatly decrease postoperative pain. However, in many areas, there still exists a phenomenon of surgeons using wound infiltration (WI) with conventional local anesthetics (not liposome anesthetics) as the main means to decrease postoperative pain because of traditional wisdom or convenience. Here, we compared the analgesic effectiveness of the two different methods to determine which method is more suitable for adult patients. Materials and methods. A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing TAP block and WI without liposome anesthetics in adult patients were performed. Frequently used databases were extensively searched. The main outcomes were postoperative pain scores in different situations (at rest or during movement) and the time until the first use of rescue analgesics. The secondary outcomes were postoperative nausea and vomiting (PONV) incidence and patient satisfaction scores. Results. Fifteen studies with 983 participants met the inclusion criteria and were included in the present study. The heterogeneity in the final analysis regarding the pain score was low to moderate. The major results of the sensitivity analysis were stable. WI had the same analgesic effect as TAP block only at the one-hour postoperative time point (mean difference=−0.32, 95% confidence interval (-0.87, 0.24), P=0.26) and was associated with a shorter time until the first rescue analgesic and poorer patient satisfaction. Conclusion. TAP block results in a more effective and steady analgesic effect than WI with conventional local anesthetics in adult patients from the early postoperative period and obtains higher patient satisfaction.

scholarly journals Efficacy of Transversus Abdominis Plane Block and Rectus Sheath Block in Laparoscopic Inguinal Hernia Surgery

2015 ◽  
Vol 100 (4) ◽  
pp. 666-671 ◽  
Author(s):  
Katsushi Takebayashi ◽  
Masakata Matsumura ◽  
Yasuhiro Kawai ◽  
Takahiko Hoashi ◽  
Nagato Katsura ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Rectus Sheath ◽  
Transversus Abdominis ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Hernia Surgery ◽  
Laparoscopic Inguinal Hernia ◽  
Inguinal Hernia Surgery

We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block+ group, n = 18) or without peripheral nerve block (Block− group, n = 14). Preoperatively, TAP and RS block were performed through ultrasound guidance. We evaluated postoperative pain control and patient outcomes. The mean postoperative hospital stays were 1.56 days (Block+ group) and 2.07 days (Block− group; range, 1–3 days in both groups; P = 0.0038). A total of 11 patients and 1 patient underwent day surgery in the Block+ and Block− groups, respectively (P = 0.0012). Good postoperative pain control was more commonly observed in the Block+ group than in the Block− group (P = 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery.

scholarly journals Comparison of Efficacy of 0.25 % Ropivacaine with Dexmedetomidine versus 0.25 % Ropivacaine Alone for Transversus Abdominis Plane Block for Post-Operative Analgesia in Patients Undergoing Lower Segment Caesarean Section - A Prospective Randomized Clinical Study

2021 ◽  
Vol 8 (17) ◽  
pp. 1133-1138
Author(s):  
Shraddha Agrawal ◽  
Avan Suryawanshi ◽  
Alok Kumar Swain ◽  
Arun Andappan ◽  
Ramesh Kumar M
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Ultra Sound ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Duration Of Action ◽  
Vas Scores ◽  
Safe Condition

BACKGROUND Regional anaesthesia is an armamentarium in the hands of the anaesthesiologist to provide swift, effective and safe condition for surgery. However, local anaesthetics are characterised by slower onset and shorter duration of action, when used in larger doses can cause systemic toxicity. Hence, adjuvants are used to better the quality of blocks. Here, I have used dexmedetomidine as an adjuvant in transversus abdominis plane (TAP) block to assess duration of action, hemodynamic effects and side-effects. METHODS Our study is randomised double blinded comparative study, in which we have compared two groups, one received ropivacaine alone and another received ropivacaine with dexmedetomidine as an adjuvant. Assessment was done for duration of action, visual analog scale (VAS) scores, analgesic drug usage, sedation scoring and incidence of side-effects and complications. This study was conducted on 94 parturients with 47 patients in each group. RESULTS Dexmedetomidine has a statistically significant prolonged action and has given excellent analgesia post-operatively. Additional analgesics were required in a lesser number than the control group. There were no hemodynamic disturbances and complications. CONCLUSIONS Dexmedetomidine added to ropivacaine for ultra-sound guided TAP block is associated with prolonged and excellent analgesia with lesser requirement for additional analgesic usage, lower VAS scores, hemodynamic stability, and minimal sedation. KEYWORDS Caesarean Section, Dexmedetomidine, Analgesia, Post-Operative, Ropivacaine, Transversus Abdominis Plane Block

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