Comparison of Analgesic Efficacy of Laparoscope-Assisted and Ultrasound-Guided Transversus Abdominis Plane Block after Laparoscopic Colorectal Operation: A Randomized, Single-Blind, Non-Inferiority Trial

Surgeon-delivered laparoscopic transversus abdominis plane blocks are non-inferior to anesthesia-delivered ultrasound-guided transversus abdominis plane blocks: a blinded, randomized non-inferiority trial

“…[4,7] Laparoscopically guided TAP blocks have been gaining popularity in recent years and several studies have demonstrated their efficacy, however, direct comparisons between LTAPs and UTAPs are lacking. [14][15][16][17][18] One previous study examined LTAP vs. UTAP in Korean patients undergoing colorectal resections demonstrated that LTAP was non-inferior although the primary outcome was subjective pain scores. Our findings build upon those of Park and colleagues in several important ways.…”

“…Our findings build upon those of Park and colleagues in several important ways. [15] First, these authors employ an intraabdominal approach to LTAP using a laparoscopic needle rather than a percutaneous technique, which requires specialized equipment for administration. Second, our patients more accurately reflect the United States population with a mean BMI of 29.3 as compared to their cohort with a mean BMI of 24.…”

“…The primary outcome in this study was post-operative opioid requirement as compared to other studies that have focused primarily on patient reported pain scores. [10,15] We felt that an emphasis on the objective measure of post-operative opiate requirement was more generalizable, and thus we chose that value as our primary outcome. Opiate requirement differs among patients both in effective dose and agent and this variation is reflected in the wide range of dosage used by patients in this study.…”

“…Recently, there have been several reports of localizing the TAP injection using laparoscopic guidance. [14][15][16][17] Laparoscopically guided TAP blocks (LTAPs) have the potential to decrease resource utilization including time, provider, and cost. The comparative efficacy of surgeon delivered LTAPs versus anesthesia delivered UTAPs has only twice been studied in colorectal surgery; employing different delivery techniques and in populations with unclear generalizability to the average colorectal surgery practice.…”

“…The comparative efficacy of surgeon delivered LTAPs versus anesthesia delivered UTAPs has only twice been studied in colorectal surgery; employing different delivery techniques and in populations with unclear generalizability to the average colorectal surgery practice. [15,18] Therefore we aimed to address this gap in the current understanding of the relative efficacy of LTAP and UTAP through a prospective trial. We hypothesized that surgeon delivered LTAPs would be non-inferior to anesthesia delivered UTAPs in terms of post-operative pain control.…”