Analgesic Efficacy of Preemptive Transversus Abdominis Plane Block in Patients Undergoing Laparoscopic Colorectal Cancer Surgery.

Kwan Young Hong ,Hue Jung Park,Won Gook Wi,Woo Seog Sim ,Woo Yong Lee ,Hee Cheol Kim ,Duk Kyung Kim ,Jin Young Lee

doi:10.3390/jcm9051577

Abstract

Despite rapid advancements in laparoscopic surgical devices and techniques, pain remains a significant issue. We examined the efficacy of preemptive transversus abdominis plane (TAP) block for acute postoperative pain in patients undergoing laparoscopic colorectal cancer surgery. We retrospectively analyzed 153 patients who underwent laparoscopic colorectal cancer surgery with or without TAP block; among them, 142 were allocated to the TAP or non-TAP group. We performed between-group comparisons of demographic, clinical, and anesthetic data and pain scores at a postoperative anesthesia care unit (PACU) and at postoperative days 1, 3, and 5. There were no significant between-group differences in demographic and clinical characteristics. The mean arterial pressure, heart rate, and minimum alveolar concentration (MAC) were significantly lower in the TAP group at the start and end of surgery. The post-extubation bispectral index was significantly higher in the TAP group. There were no significant between-group differences in the pain scores and opioid consumption at the PACU or at postoperative days 1, 3, and 5, or in the time to pass flatus, the hospital stay length, and postoperative complications. Preemptive TAP block showed an intraoperative, but not postoperative, analgesic effect, characterized by a low mean arterial pressure, heart rate, and MAC.

Highlights

Despite rapid advancements in laparoscopic surgical devices and techniques, postoperative pain remains a significant clinical issue [1,2,3]
There were no significant differences in the postoperative pain scores across the time points from PCAU to postoperative days (PODs) 5 (Table 3)
This study aimed to evaluate whether preemptive transversus abdominis plane (TAP) block with ropivacaine and hydromorphone exerts an analgesic effect on acute postoperative pain in patients undergoing laparoscopic colorectal cancer surgery

Summary

Introduction

Despite rapid advancements in laparoscopic surgical devices and techniques, postoperative pain remains a significant clinical issue [1,2,3]. As an element of multimodal analgesia for enhanced recovery after surgery (ERAS), transversus abdominis plane (TAP) block has varying efficacy degrees [10,11,12]. Damadi and colleagues [16] reported that the combined use of TAP block and the ERAS pathway reduced the use of postoperative narcotics, time to ambulation and bowel function, and hospital stay length in laparoscopic colorectal surgeries. A recent study reported that TAP block with liposomal bupivacaine decreased postoperative pain within a 3 day follow up after open and laparoscopic colorectal surgery [20]. We aimed to evaluate the analgesic efficacy of preemptive TAP block with ropivacaine and hydromorphone in patients undergoing laparoscopic colorectal cancer surgery

Objectives

Methods

Results

Discussion

Conclusion