scholarly journals Transversus Abdominis Plane Versus Ilioinguinal and Iliohypogastric Nerve Blocks for Analgesia Following Open Inguinal Herniorrhaphy

2016 ◽  
Vol 7 (3) ◽  
pp. e0021 ◽  
Author(s):  
Anatoli Stav ◽  
Leonid Reytman ◽  
Michael-Yohay Stav ◽  
Anton Troitsa ◽  
Mark Kirshon ◽  
...  
Keyword(s):  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Nerve Blocks ◽  
Inguinal Herniorrhaphy ◽  
Plane Versus ◽  
Open Inguinal Herniorrhaphy

scholarly journals Comparison of Three Different Doses of Dexmedetomidine Added to Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block; A Randomized Clinical Trial

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Gilda Talebi ◽  
Hassan Moayeri ◽  
Khalid Rahmani ◽  
Karim Nasseri
Keyword(s):  
Controlled Trial ◽  
Optimal Dose ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Inguinal Herniorrhaphy ◽  
Analgesic Effects ◽  
To Receive ◽  
Open Inguinal Herniorrhaphy

Background: Adding dexmedetomidine to bupivacaine has been shown to prolong the analgesic effects of the transversus abdominis plane (TAP) block. However, the optimal dose of this adjuvant drug is unclear. Objectives: Identifying optimal doses of dexmedetomidine added to bupivacaine in the TAP block. Methods: In this randomized controlled trial, 86 patients candidate for elective open inguinal herniorrhaphy under spinal anesthesia were divided randomly into three groups; low (L), medium (M), and high (H) dose of dexmedetomidine, that finally 80 cases ended the study and were analyzed. At the end of the surgery, the patients underwent ultrasound-guided TAP block. In all patients of the three groups, the analgesic base of the block was 20 mL bupivacaine 0.125% that was supplemented with 0.5, 1, or 1.5 µ/kg of dexmedetomidine in groups L, M, and H, respectively. Results: The maximum duration of the block was 4 hours in group L and 8 hours in groups M and H. None of the patients needed to receive analgesic at 0, 2, and 24 hours after the block. The dose of analgesic required in the first 8 hours of the block in groups M and H was less than in group L (P < 0.02). Patients in groups H and M were more satisfied with the block (P < 0.01) and experienced less pain compared with group L (P < 0.01). Drowsiness and sedation were observed in patients up to 4 hours after the TAP block, which was dependent on the dexmedetomidine dose (P < 0.01). Conclusions: Based on our results, the optimal dose of supplemental dexmedetomidine could be 1 µ/kg in the TAP block.

scholarly journals Adding low concentrations of clonidine to ropivacaine for transversus abdominis plane blocks does not reduce plasma ropivacaine levels, suggesting a lack of vasoconstrictor effect

2019 ◽  
Vol 47 (2) ◽  
pp. 134-140
Author(s):  
Jennifer M Crawford ◽  
John A Loadsman ◽  
Kenny XF Yang ◽  
Peter CA Kam
Keyword(s):  
Local Anaesthetics ◽  
Transversus Abdominis ◽  
Control Group ◽  
Transversus Abdominis Plane ◽  
Nerve Blocks ◽  
Duration Of Action ◽  
Low Concentrations ◽  
Vasoconstrictor Effect ◽  
Surrogate Measure ◽  
To Receive

Clonidine has been used successfully to prolong the duration of action of local anaesthetics in peripheral nerve blocks, but its mechanism of action in this setting remains unclear. Some studies suggest that clonidine exerts a vasoconstrictor effect, limiting the washout of local anaesthetic from its site of deposition. We investigated this potential vasoconstrictor effect, using plasma ropivacaine concentrations as a surrogate measure of vasoconstriction, in patients who received transversus abdominis plane (TAP) blocks with and without clonidine. Eighty women undergoing laparoscopic gynaecological surgery were randomly assigned to receive one of four TAP block solutions: 0.2% ropivacaine (control), ropivacaine with clonidine 2 μg/kg (clonidine), ropivacaine with 1:400,000 adrenaline (adrenaline) or ropivacaine and a subcutaneous injection of clonidine 2 μg/kg (SC clonidine). The primary outcome was total venous plasma ropivacaine concentrations up to 6 h after the block. There were no significant differences in plasma ropivacaine concentrations between the control group and the clonidine group at any timepoint in the study, nor were there differences in either the mean maximum ropivacaine concentration ( Cmax) (1.99 μg/mL versus 2.05 μg/mL, P = 0.712) or the time to maximum concentration ( Tmax) (51.0 min versus 56.0 min, P = 0.537). The SC clonidine group also did not differ significantly from the controls ( Cmax 2.13 μg/mL versus 1.99 μg/mL, P = 0.424; Tmax 43.5 min versus 51.0 min, P = 0.201). Plasma ropivacaine concentrations in the adrenaline group were significantly lower than the controls from 10 to 90 min ( P < 0.003 for each comparison), and the Cmax was less than that of the control group (1.36 μg/mL versus 1.99 μg/mL, P < 0.001) with a longer Tmax (103.5 min versus 51.0 min, P = 0.001). These findings indicate that clonidine at a concentration of 1.35 μg/mL added to ropivacaine for TAP blocks did not produce a reduction in plasma ropivacaine concentrations. This suggests a lack of vasoconstrictor effect during TAP blocks. Further studies should evaluate whether vasoconstriction occurs when clonidine is used at higher concentrations or for other blocks.

Transversus Abdominis Plane and Rectus Sheath Blocks

2021 ◽  
pp. 81-88
Author(s):  
Natalea Johnson ◽  
Jorge A. Pineda
Keyword(s):  
Abdominal Wall ◽  
Umbilical Hernia ◽  
Visceral Pain ◽  
Rectus Sheath ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Nerve Blocks ◽  
Rectus Sheath Block ◽  
Intercostal Nerves

Chapter 9 discusses truncal peripheral nerve blocks, which are utilized for supplemental analgesia for abdominal surgeries by providing local anesthesia to the anterior abdominal wall. These blocks are adjuvants because they will not block visceral pain. Unilateral analgesia to the skin, muscles, and parietal peritoneum of the abdominal wall is achieved. The transversus abdominis plane block (TAP) reliably provides analgesia to the lower abdominal wall in the T10–L1 distribution. Rectus sheath blocks anesthetize the terminal branches of the lower thoracic intercostal nerves and provide midline analgesia from the xiphoid process to the umbilicus. Surgical indications for TAP blocks include laparotomies, laparoscopies, inguinal hernia repairs, and appendectomies. Rectus sheath block indications include midline surgeries such as single-port appendectomies and umbilical hernia repairs.

Transversus Abdominis Plane Block Vs. Paravertebral Block for Post-Operative Analgesia Following Inguinal Herniorrhaphy - A Cross-Sectional North Indian Sub-Population Study

2021 ◽  
Vol 8 (31) ◽  
pp. 2880-2884
Author(s):  
Trilok Chand ◽  
Amrita Gupta ◽  
Avanish Kumar Saxena ◽  
Pulkit Agarwal ◽  
Shanu Maheshwari
Keyword(s):  
Inguinal Hernia ◽  
Demographic Data ◽  
Paravertebral Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia ◽  
Inguinal Herniorrhaphy ◽  
Vas Score ◽  
Post Operative Pain

BACKGROUND Inguinal hernia is a frequently encountered surgical problem. General anaesthesia carries the risk of possible airway complications. Regional blocks improve acute post-operative pain, decrease post-operative visual analogue scale (VAS) score and patient can mobilise early. The purpose of this study was to compare the effectiveness of transversus abdominis plane (TAP) block vs. paravertebral (PVB) block for post-operative analgeia in inguinal hernia surgeries. METHODS We conducted a research on 64 patients of age > 18 years with American society of Anaesthesiologists (ASA I – III) to undergo unilateral inguinal herniorrhaphy. Patients were randomized into two groups. Group T received TAP block in which 20 ml of 0.25 % bupivacaine was injected and Group P underwent PVB in which 5 ml of bupivacaine (0.25 %) at each segment from T10-L1 was injected slowly (total dose of 20 ml). Post-operative VAS score, time for first rescue analgesia, total diclofenac requirement, total anti-emetic requirement and complications if any was noted. RESULTS The demographic data of both the groups were comparable. Also, pre and postoperative heart rate, blood pressure, IV fluids, ephedrine use, operative time and complications were statistically insignificant. As compared to group T, group P had lower VAS score from 2nd – 12th hour which was statistically significant (P < 0.05). Although more time is required to perform paravertebral block but the time for request of first rescue analgesia was quite prolonged in paravertebral block. Time of ambulation in group P was significantly lower than group T. CONCLUSIONS PVB requires more time to perform due to multiple site of injection, the comparison of both techniques in the present study revealed that PVB showed relatively higher efficacy in the management of post-operative pain, early ambulation and had significant reduction in dose requirement of additional analgesia (diclofenac) and antiemetics (ondansetron) over tap block. KEYWORDS Paravertebral Block, Transversus Abdominis Block, Inguinal Hernia

Trunk and Spine Ultrasound Guided Regional Anesthesia

2016 ◽  
Author(s):  
Stuart A. Grant ◽  
David B Auyong
Keyword(s):  
Regional Anesthesia ◽  
Rectus Sheath ◽  
Transversus Abdominis ◽  
Clinical Anatomy ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Risks And Benefits ◽  
Quadratus Lumborum ◽  
Tools And Techniques

This chapter describes the clinical anatomy and outlines the tools and techniques needed to perform thoracic, abdominal and neuraxial ultrasound-guided procedures. The nerve blocks described here include the transversus abdominis plane (TAP), quadratus lumborum, ilioinguinal-iliohypogastric, rectus sheath, intercostal, PECS, serratus plane, paravertebral, and neuraxial spinal and epidural blocks. For each nerve block, the indications, risks, and benefits of the varying approaches are described in detail. The chapter includes step-by-step instructions with illustrations to allow the operator to perform clinically effective and safe ultrasound-guided thoracic, truncal, and neuraxial procedures. At the conclusion of each block description, a “Pearls” segment highlights important tips gleaned from our clinical experience. This chapter provides the practitioner with thorough instruction and knowledge allowing the optimal delivery of regional anesthesia for any thoracic or abdominal surgery.

scholarly journals Continuous Transversus Abdominis Plane Nerve Blocks

2017 ◽  
Vol 124 (4) ◽  
pp. 1298-1303 ◽  
Author(s):  
Bahareh Khatibi ◽  
Engy T. Said ◽  
Jacklynn F. Sztain ◽  
Amanda M. Monahan ◽  
Rodney A. Gabriel ◽  
...  
Keyword(s):  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Nerve Blocks
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