An Anatomical Study of the Transversus Abdominis Plane Block: Location of the Lumbar Triangle of Petit and Adjacent Nerves

Jankovic, Zorica; Feu, Frances M du; McConnell, Patricia

doi:10.1213/ane.0b013e3181ae0989

Cited by 102 publications

(86 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 Jankovic et al have demonstrated the exact location of nerves needed to be blocked in petite triangle (inferior lumbar triangle) to get good block. 9 The current study was lacking a few aspects like we did not determine the duration of the TAP block and the exact volume needed on body weight basis. Also, we did not assess postoperative nausea and vomiting in the PACU.…”

Section: Discussionmentioning

confidence: 96%

Intraoperative Ultrasound-guided Transversus Abdominis Plane Block in Lower Abdominal Surgery

Khan¹,

Nawaz²,

Delvi³

et al. 2012

IJPUT

View full text Add to dashboard Cite

Background: Ultrasound-guided transversus abdominis plane (TAP) block has been used for analgesia in lower abdominal surgery. In the literature, there are inconsistent reports regarding the efficacy of TAP block in different open abdominal procedures. Therefore, we conducted this prospective randomised doubleblind study to evaluate the pattern of perioperative analgesia and to validate the efficacy of TAP block in patients undergoing lower abdominal surgery.

show abstract

Section: Discussionmentioning

confidence: 96%

Intraoperative Ultrasound-guided Transversus Abdominis Plane Block in Lower Abdominal Surgery

Khan¹,

Nawaz²,

Delvi³

et al. 2012

IJPUT

View full text Add to dashboard Cite

show abstract

“…It supplies the upper and medial part of the thigh and part of the skin covering the genitalia. (3) The transverus abdominis plane thus provides a space in to which local anesthetic can be deposited to achieve myocutaneous sensory blockade 17,25 The dose of the drug used was bupivacaine 0.25% 20ml on each side, maximum dose being 2mg/k.g. higher recommended dose of bupivacaine was used to provide prolonged analgesia with single shot technique.…”

Section: Discussionmentioning

confidence: 99%

Transversus Abdominis Plane Block : A Complementary Technique for Post Operative Analgesia in Lower Abdominal Gynecological Cancer Surgeries

Arathi¹,

Ramamani²,

Gowda³

et al. 2015

jemds

View full text Add to dashboard Cite

BACKGROUND: Gynecological cancer surgeries differ from non-cancer surgeries as the former involves extensive dissection, and tissue handling, which contributes to increased nociception perioperatively. Radical hysterectomy with pelvic lymph node dissection is one of the most commonly performed surgeries in gynecological oncological set up. Transversus abdominis plane (TAP) block is one of the new promising regional anesthesia technique complementing multi modal analgesic regimen. This is a prospective randomized controlled trial. We evaluated the role of the TAP block in Radical hysterectomy with pelvic lymph node dissection for perioperative analgesia and reducing the requirement of opioid consumption. METHODS: 100 patients of ASA grade 1 and 2 undergoing radical hysterectomy and pelvic lymph node dissection with below umbilical incision were randomized as block group to undergo TAP block with bupivacaine 0.25% 20ml on each side (n=50), versus non-block group (n=50). All patients received general anesthethesia. Block was performed before surgical incision bilaterally by using blind double pop technique in patients who were randomized to the block group. Intra operative analgesic regimen was with inj fentanyl 1.5 mic/k.g, repeated with 0.5mic/k.g depending on the requirement as assessed by the anaesthesiologist based on haemodynamic parameters and post operatively by pain scores on numeric visual analogue scale with inj. paracetamol 1gm followed by tramadol 2mg/kg and fentany 0.5mic/kg. Each patient was assessed post operatively at 0, 2, 4, 6, 8,12,16,20,24 hours for pain, nausea, vomiting and sedation. The data recorded. Descriptive and inferential statistical analysis has been carried out using student t test, chi square/ fisher exact test in the present study. RESULTS: We studied 100 patients, 50 patients in block group and 50 patients in non-block group. The block group had significantly less pain scores compared to non-block group, p value being < 0.001. Total requirement of opioids in 24 hours was reduced in the block group, p<0.001. Time to first request for analgesia was delayed in the block group where only 22% patients needed analgesic at 0 hours compared to 72% in non-block group. Incidence of nausea and vomiting was reduced after 4 hours in block group. The non-block group patients were less sedated at 0 and 2 hours probably due to pain. There were no complications attributable to the block. CONCLUSION: TAP block as a complementary technique to the multimodal analgesia protocol, provided improved quality of analgesia with reduced opioid requirement and their side effects in block group compared to non-block group for radical hysterectomy and pelvic lymph node dissection with incision below the umbilicus KEYWORDS: Post-operative pain, regional anaesthesia technique. INTRODUCTION:Gynecological cancer surgeries differ from non-cancer surgeries as the former involves extensive dissection, and tissue handling, hence contributes to increased nociception perioperatively. Radical hysterectomy with...

show abstract

“…However, the triangle is highly variable in site and presence. 19,47,48 Consequently, the ultrasonography guided technique was described. 49 Other technical variants include a 'multiple injection' Figure 6 Mean length of hospital stay technique and continuous infusion via a subcutaneous catheter.…”

Section: Addition Of Transversus Abdominis Plane Block To Patient Conmentioning

confidence: 99%

Addition of transversus abdominis plane block to patient controlled analgesia for laparoscopic high anterior resection improves analgesia, reduces opioid requirement and expedites recovery of bowel function

Ris

Findlay

Hompes

et al. 2014

annals

View full text Add to dashboard Cite

INTRODUCTION Opioid sparing in postoperative pain management appears key in colorectal enhanced recovery. Transversus abdominis plane (TAP) blocks offer such an effect. This study aimed to quantify this effect on pain, opioid use and recovery of bowel function after laparoscopic high anterior resection. METHODS This was a retrospective analysis of prospective data on 68 patients. Patients received an epidural (n=24), intravenous morphine patient controlled analgesia (PCA, n=22) or TAP blocks plus PCA (n=22) determined by anaesthetist preference. Outcome measures were numerical pain scores (0-3), cumulative intravenous morphine dose and time to recovery of bowel function (passage of flatus or stool). RESULTS There were no differences in patient characteristics, complications or extraction site. The TAP block group had lower pain scores (0.7 vs 1.36, p<0.001) and morphine requirements (8mg vs 15mg, p=0.01) than the group receiving PCA alone at 12 hours and 24 hours. Earlier passage of flatus (2.0 vs 2.7 vs 3.4 days, p=0.002), stool (3.1 vs 4.1 vs 5.5 days, p=0.04) and earlier discharge (4 vs 5 vs 6 days, p=0.02) were also seen. CONCLUSIONS Use of TAP blocks was found to reduce pain and morphine use compared with PCA, expedite recovery of bowel function compared with PCA and epidural, and expedite hospital discharge compared with epidural.

show abstract

An Anatomical Study of the Transversus Abdominis Plane Block: Location of the Lumbar Triangle of Petit and Adjacent Nerves

Cited by 102 publications

References 9 publications

Intraoperative Ultrasound-guided Transversus Abdominis Plane Block in Lower Abdominal Surgery

Intraoperative Ultrasound-guided Transversus Abdominis Plane Block in Lower Abdominal Surgery

Transversus Abdominis Plane Block : A Complementary Technique for Post Operative Analgesia in Lower Abdominal Gynecological Cancer Surgeries

Addition of transversus abdominis plane block to patient controlled analgesia for laparoscopic high anterior resection improves analgesia, reduces opioid requirement and expedites recovery of bowel function

Contact Info

Product

Resources

About