Feasibility and perioperative pain-relieving efficacy of ultrasound-guided transversus abdominis plane block in morbidly obese patients undergoing laparoscopic bariatric surgery

Abstract

Background The implementation of adequate postoperative analgesia is beneficial in morbidly obese patients. Transversus abdominis plane (TAP) block is a new regional anesthetic technique that has been implemented successfully for pain control after laparoscopic surgery in nonobese patients, and is challenging to perform on obese patients. The introduction of ultrasound guidance has enabled greater precision of needle placement in the desired tissue plane in such patients. Patients and methods Hundred patients were included in this study. Patients were assigned randomly to two equal groups: group 1 (TAP, n = 50) and group 2 (control, n = 50). The following parameters were recorded: total volume of morphine consumed, numeric rating scores at rest and on coughing, postoperative nausea and vomiting, time to mobilization, patient, and surgeon satisfaction scores. Results Lower numeric rating scores was reported among patients who received TAP block; cumulative morphine consumption was consistently lower at 24 and 48 h, postoperatively. Patient satisfaction with pain relief was rated as good by 85% of the patients in the TAP block group and 45% of the patients in the control group. Conclusion Ultrasound-guided TAP block is a feasible technique for effective multimodal postoperative analgesia in morbidly obese patients undergoing laparoscopic sleeve gastrectomy.