Effect Of Transversus Abdominis Plane Block Research Articles

Quadratus Lumborum Block versus Transversus Abdominis Plane Block for Laparoscopic Radical Resection for Rectal Cancer

Background: Both transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) can provide effective analgesia for abdominal surgery. Objectives: To explore whether there are differences in the effects of TAPB and QLB on the quality of postoperative recovery in patients undergoing laparoscopic radical resection for rectal cancer. Methods: In total, 102 patients undergoing laparoscopic radical resection for rectal cancer were randomly divided into two groups. Bilateral TAPB or QLB was performed using 0.375% ropivacaine after the induction of anesthesia. The 15-item Quality of Recovery (QoR-15) scale was used to assess the quality of recovery at 24 h postoperatively. Secondary indicators included 24-h postoperative fentanyl consumption, patient-controlled analgesia (PCA), incidence of adverse reactions, numerical rating scale (NRS) at rest and during exercise, and incidence of postoperative complications. Results: QoR-15 scores were higher in the QLB group than in the TAPB group (115.6±11.3 vs. 99.7±14.2, P<0.05). Moreover, the 24-h sufentanil consumption was less in the QLB group than in the TAPB group (2.4±0.5 vs. 5.5±0.3 μg, P<0.05) after surgery. Time durations to first postoperative PCA compression were 152.1±28.4 and 100.3 ± 22.9 min, respectively (P<0.05). The numbers of PCA compressions within 24 h after surgery were 6.0 (2.0, 8.0) and 9.0 (3.0, 12.0) (P<0.05). There were no differences in secondary outcomes, such as adverse reactions, NRS scores at rest and exercise at 24 h postoperatively, as well as complication rates. Conclusion: Patients undergoing laparoscopic radical resection for rectal cancer with QLB had a better quality of recovery and better analgesic effects at 24 h postoperatively, compared to TAPB

Ultrasound-Guided Transversus Abdominis Plane Block in laparoscopic surgeries: A scoping review

ABSTRACT Background Pain following laparoscopic surgeries is a major concern that has been managed by several modalities with varying results. Ultrasound-Guided Transversus Abdominis Plane Block (TAPB) is considered a modality that may help decrease postoperative pain and opioid consumption and its related side effects which may contribute to reduction of hospital stay and improvement in functional recovery. Objective The aim of this scoping review was to demonstrate the efficacy of ultrasound guided TAPB for pain relief following laparoscopic surgeries and its effect on minimizing opioid consumption and incidence of side effects Method This scoping review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review guidelines. A search of PubMed, Scopus, and Web of Science databases was conducted. The titles and abstracts of potentially relevant studies were screened before the retrieval of the full texts, which were then examined to determine which studies met the eligibility criteria (adult patients, receiving TAPB and undergoing laparoscopic surgeries, English language, full text articles related to TAPB and laparoscopic surgeries) Results One hundred and seventeen potentially eligible studies were identified. 98 records were excluded as they were either duplicates or did not meet the eligibility criteria leaving 19 articles. 13 articles were found discussing the efficacy of TAPB on pain intensity, most of which concluded that TAPB provided superior pain relief when compared with other methods. Most of the reviewed articles found no significant difference in the incidence of postoperative nausea and vomiting (PONV) or the quality of functional recovery among patients who received TAPB. Conclusion This scoping review suggests that TAPB is an effective technique for analgesia following laparoscopic surgeries. Further studies are required to better elucidate the effects of TAPB on the incidence of side effects and on patients’ functional recovery due to the limited number of reports discussing these outcomes.

Efficacy of transversus abdominis plane (TAP) block in colorectal surgery: a systematic review and meta-analysis.

Multimodal opioid-sparing analgesia is a key component of the enhanced recovery after surgery (ERAS) protocol for postoperative pain management. Transversus abdominis plane (TAP) block has contributed to the implementation of this approach in different kinds of surgical procedures. The aim of this study was to evaluate the efficacy of TAP block and its impact on recovery in colorectal surgery. A comprehensive literature search of the PubMed, Embase, and Scopus databases was conducted. Studies that compared TAP block to a control group (no TAP block or placebo) after colorectal resections were included. The effects of TAP block in patients undergoing colorectal surgery were assessed, including the technical aspects of the procedure. Two measures were used to evaluate the effectiveness of postoperative pain control: a numeric pain rating score at rest and on coughing or movement at 24h following surgery and the opioid requirement at 24h. Clinical aspects of recovery were postoperative ileus, surgical site infection, postoperative nausea and vomiting, and length of hospital stay. Sixteen studies were included in the analysis. Data showed that TAP block is a safe procedure associated with a significant reduction in the pain score at rest [WMD - 0.91 (95% CI - 1.56; - 0.27); p < 0.05] and on coughing or movement [WMD - 0.36 (95% CI - 0.72; - 0.01); p < 0.05] at 24h after surgery and a significant decrease in morphine consumption in the TAP block group the day after surgery [WMD - 2.07 (95% CI - 2.63; - 1.51); p < 0.001]. TAP block appears to provide both an effective analgesia and a significant reduction in opioid use on the first postoperative day after colorectal surgery. Its use does not seem to lead to increased postoperative complications.

Effectiveness of Transversus Abdominis Plane Block as part of a Multimodal Analgesia to Reduce Opioid Consumption among Total Abdominal Hysterectomy Patients: A Randomized Control Trial

Background:Generally patients after total abdominal hysterectomy have suffered from moderate tosevere postoperative pain. Multimodal approach are using to reduce this pain. Objective:The purpose of the present study was to observe the effectiveness of transversus abdominisplane block as part of amultimodal analgesia to reduce opioid consumption among total hysterectomypatients. Methodology:This randomized control trial was conducted in Department of Anaesthesia, Analgesia,Palliative and Intensive Care Medicine of Dhaka Medical College and Hospital, Dhaka, Bangladeshfrom March 2016 to September 2018 for a period two years and six months. Women planned for anelective total abdominal hysterectomy under general anesthesia were selected as study population.Participants were selected and randomly divided into two groups designed as group I and group II.Patient of both group were given general anesthesia. Group I patient received 20 ml 0.25% bupivacaineand group II patient received 20 ml normal saline as placebo. Then dressing was done. The TAP blockwas performed after taking all aseptic precaution in the flank palpated between the 12th rib (Costalmargin) and the iliac crest. After confirmation of correct position, 20 ml 0.25% bupivacaine was given togroup I patient and 20 ml normal saline was given to group II patient within the fascial layer whichwas confirmed by ultrasound. Result:A total number of 40 patients were recruited for this study and were equally divided into twogroups. Thus 20 patients were in the group I and the rest 20 patients were in group II. The mean age ofgroup I were 53.08 ±4.25 and group II were 51.5±4.97 (p= 0.286).In this study 5(25.0%) patients hadnausea in group I and 8(40.0%) in group II, 3(15%) patients had vomiting in group I and 4(20.0%) ingroup II (p&gt;0.05). The mean first analgesic demand was 8.39±1.85 hours in group I and 1.59±0.21 hoursin Group II (p=0.001).The mean total morphine consumption was 14.78±3.56 in group I and 26.30±5.9in group II (p&lt;0.05). Conclusion:TAP block effectively reduced the total postoperative morphine consumption. JBSA 2020; 33(1): 16-21

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

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.&#x0D; Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section.&#x0D; 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.&#x0D; 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.&#x0D; Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

Efficacy of ultrasound-guided transversus abdominis plane block in breast reconstruction surgery with abdominal myocutaneous flap

Background: Ultrasound (US)-guided transversus abdominis plane block (TAPB) provides postoperative analgesic efficacy in abdominal surgery, however evidence of its efficacy in reconstructive breast surgery with transversus rectus abdominis myocutaneous (TRAM) flap is still limited. Our main objective was to assess effectiveness of TAPB in this surgery. Methods: Observational retrospective study conducted in patients undergoing unilateral breast reconstruction with TRAM (surgery 1) and mastectomy (partial or total) followed by TRAM reconstruction (surgery 2) from April 2015 to June 2017. Two anaesthetic plans were analysed: general balanced anaesthesia (GBA) and combined GBA with bilateral TAPB (GBA+TAPB). Primary outcomes were total intraoperative administered fentanyl, total consumed morphine in postoperative anaesthesia care unit (PACU) and time between conclusion of surgery and first requested analgesic (analgesia time). Results: 107 patients were included: 80 submitted to surgery 1 and 27 submitted to surgery 2. In surgery 1, intraoperative fentanyl consumption and administered morphine, during the patients’ stay at PACU, were lower in GBA+TAPB than in GBA group (p Regarding surgery 2, globally no significant differences were identified between both groups. No complications associated to local anaesthetics or TAPB were registered. Conclusion: US-guided bilateral TAPB resulted in lower opioid consumption and better pain control in unilateral breast reconstruction surgery with TRAM.

Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review.

BackgroundAdverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine (LB) to reduce post-cesarean pain is unknown.MethodsWe performed a single-center retrospective chart review of patients aged ≥18 years who underwent cesarean delivery with a multimodal pain management protocol with or without TAP block with LB 266 mg. Assessments included postsurgical opioid consumption; area under the curve (AUC) of numeric rating scale pain scores from 0 to 3 days; proportion of opioid-free patients; discharge- and post-anesthesia care unit (PACU)-ready time; times to ambulation, solid food, and bowel movement; hospital length of stay (LOS); and adverse events (AEs). Data were analyzed in the total population and in first- and repeat-cesarean subgroups using Wilcoxon, chi-squared, and Student’s t-tests.ResultsOf 201 patients, 101 were treated with LB TAP block (LB-TAPB) and 100 without LB-TAPB. Treatment with LB-TAPB vs without LB-TAPB significantly reduced mean post-surgical opioid consumption (total, 47%; first-cesarean, 54%; repeat-cesarean, 42%; P<0.001 each) and mean AUC of pain scores (total, 46%; first-cesarean, 57%; repeat-cesarean, 40%; P<0.001 each). Patients treated with LB-TAPB had significantly shorter mean discharge-ready times (2.9 vs 3.6 days; P=0.006), PACU-ready times (138 vs 163 minutes; P=0.028), and LOS (2.9 vs 3.9 days; P<0.001). LB-TAPB significantly decreased mean times to ambulation and solid food by 39% and 31% (P<0.01 each), respectively, and numerically reduced mean time to bowel movement (26%; P=0.05). Fewer patients treated with LB-TAPB vs without LB-TAPB reported an AE (34% vs 50%; P=0.026).ConclusionThese results suggest multimodal pain management incorporating TAP block with LB 266 mg is an effective approach to reducing opioid requirements and improving analgesia post-cesarean delivery.