Continuous transversus abdominis plane block catheter analgesia for postoperative pain control in renal transplant

Farag, Ehab; Guirguis, Maged; Helou, Mada; Dalton, Jarrod E.; Ngo, Fallon H; Ghobrial, Michael; OʼHara, Jerome F.; Seif, John; Krishnamurthi, Venkatesh; Goldfarb, David A.

doi:10.1007/s00540-014-1855-1

Cited by 42 publications

(38 citation statements)

References 16 publications

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“…A prior research study revealed and displayed that sonographic guided continuous TAP Blockage have similar analgesic impact as regards somatic pain and less analgesic effects concerning visceral pain issues than does IV-patient controlled analgesia with or without single-shot TAP blockage [9,17].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2018

IJWHC

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Keywords: TAP blockage, Hysterectomy, Postoperative PainPrior research groups of investigators have shown that Transversus Abdominis Plane blockage is of great value in pain management in the abdominal surgery procedures [7,8,9,10].Most research studies investigating Transversus abdominis plane blockage have used the single-shot approach. On the other hand, Abstract Background: Transversus abdominis plane blockage technique is performed by administration of local anesthetic agent between the abdominal muscle anatomical planes to block the somatic nervous innervation. Value of continuously infused local anesthetic agents via indwelling catheters in TAP blockage is an area of growing research interest.Aim: To compare the analgesic efficacy of single shot versus continuous transversus abdomin is plane (TAP) block in cases undergoing total abdominal hysterectomy.Methodology: All research study subjects enrolled had provided a written informed consent. The research study involved 60 cases having ASA scoring status 1 to 2(according to American society of Anesthesiologist scoring system), aged 35 to 60 years and scheduled to undergo total abdominal hysterectomy cases. All patients were categorized into two research groups in a random manner; single shot TAP research group (n=30 cases) and continuous TAP research group (n=30 cases).Results: VAS scoring (Visual Analog Scale for Pain) was statistically significantly lower among continuous TAP block research group in comparison to single shot TAP block research group at different time intervals,baseline,1 hour,12 hours 24 hours,36 hours 48 hours 60 hours (p values =0.000, 0.001, 0.001, 0.002, 0.026 consecutively). Conclusion and Recommendations: TAP blockage prolong the analgesic duration, reduces the VAS scoring particularly in continuous approach more than single shot postoperatively and reduces the requirements for Opioid consumption overall. www.opastonline.com Volume 4 |Issue 2 | 2 of 7 Int J Women's Health Care, 2019 www.opastonline.com

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Section: Discussionmentioning

confidence: 99%

Untitled

2018

IJWHC

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“…After major abdominal surgery, transverse abdominis plane (TAP)90 and subcostal blocks have a place in patients with coagulopathy and who are haemodynamically unstable patients. Recently, TAP catheters have also been shown to reduce postoperative opioid consumption in abdominal surgery91 and renal transplants 92. However, TAP catheters do not cover pain from the pelvic floor or visceral pain, and patients often need multimodal analgesia 91.…”

Section: Pharmacological Treatment Optionsmentioning

confidence: 99%

Analgesia in the surgical intensive care unit

Ehieli¹,

Yalamuri²,

Brudney³

et al. 2016

Postgraduate Medical Journal

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Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients. Therefore, it becomes incumbent on physicians and nurses caring for these patients to carefully evaluate their practice on pain management and adopt an optimal pain management strategy that includes a reduction in noxious stimuli, adequate analgesia and promoting education regarding sedation and analgesia to the ICU staff. Mechanistic approaches and multimodal analgesic techniques have been clearly demonstrated to be the most effective pain management strategy to improve outcomes. For example, recent evidence suggests that the use of short acting analgesics and analgesic adjuncts for sedation is superior to hypnotic based sedation in intubated patients. This review will address analgesia in the ICU, including opioid therapy, adjuncts, regional anaesthesia and non-pharmacological options that can provide a multimodal approach to treating pain.

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“…The same author described in another randomized trial that TAP catheter local anesthetic by intermittent boluses compared with epidural had no significant difference in pain scores 10. Another retrospective study on continuous TAP catheter in renal transplant patients found reduced opioid consumption 1. Although TAP block has been shown to be effective in both continuous and bolus techniques, no studies have been published comparing continuous TAP block with the intermittent bolus method.…”

Section: Introductionmentioning

confidence: 99%

Continuous transversus abdominis plane block vs intermittent bolus for analgesia after abdominal surgery: a randomized trial

Kadam¹,

Wijk²,

Moran³

et al. 2017

JPR

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BackgroundContinuous and intermittent bolus techniques of transversus abdominis plane (TAP) blocks have been used for analgesia after abdominal surgery. Although both are effective, there are no studies comparing them. The aim of this study is to compare analgesia and cost-effectiveness between these groups.MethodsAfter obtaining ethical approval, 20 American Society of Anesthesiologists ASA grade I to III patients undergoing elective abdominal surgery were recruited with 10 patients allocated to each arm. Bilateral ultrasound-guided TAP blocks were performed with an initial bolus of 0.5% ropivacaine 20 mL per side, followed by catheter insertion. After surgery, the continuous infusion group received 0.2% ropivacaine 8 mL/hour on each side and the intermittent bolus group received doses of 0.2% ropivacaine 20 mL per side every 8 hours for 48 hours. Both groups received intravenous fentanyl patient-controlled analgesia and regular oral paracetamol. Parameters recorded included numerical rating scores for pain and post-operative analgesic consumption at baseline (time 0) and at 1 hour, 1 day and 2 days post-operatively. The duration of catheter insertion, complications, patient satisfaction and information regarding costs were also recorded. Patient satisfaction was assessed utilizing a 4-point “Likert” scale on day 2 and on day 30. Pain and Likert scores were analysed by non-parametric sum rank test and all two-sampled t-tests assumed unequal variances.ResultsThere was no difference between duration of TAP block, anesthetic and surgical technique and length of stay (p=0.23). Primary outcomes: pain scores at rest and cough were not significantly different (p=0.20) between the groups. Satisfaction scores were similar at day 2 and 30 (p=0.77). However, the bolus group was more cost-effective (AU$347.98 vs AU$429.43).ConclusionContinuous or bolus TAP blocks are effective analgesic techniques in abdominal surgery, with bolus technique being more economical.

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Continuous transversus abdominis plane block catheter analgesia for postoperative pain control in renal transplant

Cited by 42 publications

References 16 publications

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Analgesia in the surgical intensive care unit

Continuous transversus abdominis plane block vs intermittent bolus for analgesia after abdominal surgery: a randomized trial

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