Efficacy of Transversus Abdominis Plane Block for Acute Postoperative Pain Relief in Kidney Recipients: A Double-Blinded Clinical Trial

Mohammadi, Sussan Soltani; Dabir, Arman; Shoeibi, Gita

doi:10.1111/pme.12311

Cited by 44 publications

(50 citation statements)

References 14 publications

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“…In a systemic review and metaanalysis that was done by Gue et al they found that the PONV incidence and sedation scores were not significant difference between TAP block and wound infiltration in most included studies [3] No complication was reported in our study, however, TAP block has some complications including vascular, abdominal viscera and nerve injuries and block failure [25]. There are some limitations to our study.…”

Section: Discussioncontrasting

confidence: 39%

Ultrasound-guided TAP Block with or without Dexmedetomidine vs. Local Infiltration of the Wound after Open Herniorrhaphy: A Randomized Prospective Controlled Study

Eldegwy¹,

Alfkey²

2017

J Anesth Clin Res

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Objectives: Transversus abdominis plane (TAP) block and local anesthetic wound infiltration (LAI) can provide a variable effective pain relief at the wound site after surgery. This prospective study was designed to evaluate the postoperative analgesic efficacy of TAP with or without dexmedetomidine compared with LAI of the wound after herniorrhaphy. Materials and methods:Sixty adult patients were divided into 3 groups of 20 patients each. Group1 (TAPD): Patients received single shot ultrasound-guided (US) TAP block using 15 mL of levobupivacaine 0.5% mixed with 0.9 μg/kg of dexmedetomidine. Group 2 (TAP): Patients received single shot US guided TAP block using 15 mL of levobupivacaine 0.5%. Group 3 (LAI): Patients received local anesthetic infiltration (LAI) patients received local infiltration using 15 mL of levobupivacaine 0.5%. The following parameters were assessed at, 2, 10, 18 and 24 h postoperatively: postoperative duration of analgesia, analgesic pain scores using the visual analogue scale (VAS) for pain, amount of supplemental intravenous morphine, postoperative nausea and vomiting during 24 h. Results:We found that a lower significant difference (P<0.05) of VAS pain scores at rest and on movement between group TAPD and group TAP at time 24 h postoperatively. Also, there was a lower significant difference (P<0.05) of VAS pain scores at rest and on movement between group TAPD and group LAI at 10, 18 and 24 h. Moreover, there was a lower significant difference (P<0.05) between group TAP and group LAI at times 10 and 18 h. Also, supplemental morphine consumption within 24 h was a statistically higher (P<0.05) in group LAI compared to groups TAPD and TAP. Conclusion:Using dexmedetomidine as an additive to levobupivacaine in ultrasound-guided TAP block for herniorrhaphy provides prolonged duration of postoperative analgesia, and lowered VAS pain scores. Also local anesthetic infiltration can give accepted postoperative analgesia but with shorter duration than TAP block

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Section: Discussioncontrasting

confidence: 39%

Ultrasound-guided TAP Block with or without Dexmedetomidine vs. Local Infiltration of the Wound after Open Herniorrhaphy: A Randomized Prospective Controlled Study

Eldegwy¹,

Alfkey²

2017

J Anesth Clin Res

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“…One RCT reported that a US-guided lateral TAP significantly reduced 24-hour opioid consumption and pain scores compared with placebo; however, patients did not receive any coanalgesics. 104 In contrast, 2 other RCTs failed to show a significant impact of landmark-guided 105 or US-guided lateral TAP 106 on 24-hour opioid consumption or pain scores in patients receiving perioperative acetaminophen. Pain scores during the first 24 hours were low in all patients.…”

Section: Renal Transplantationmentioning

confidence: 99%

Essentials of Our Current Understanding

Chin

McDonnell

Carvalho

et al. 2017

Regional Anesthesia and Pain Medicine

362

208

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Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoption of techniques including transversus abdominis plane and rectus sheath blocks, as well as the introduction of novel techniques such as quadratus lumborum and transversalis fascia blocks. These blocks are technically straightforward and relatively safe and reduce pain and opioid requirements in many clinical settings. The data supporting these outcomes, however, can be inconsistent because of heterogeneity of study design. The extent of sensory blockade is also somewhat variable, because it depends on the achieved spread of local anesthetic and the anatomical course of the nerves being targeted. The blocks mainly provide somatic analgesia and are best used as part of a multimodal analgesic regimen. This review summarizes the anatomical, sonographic, and technical aspects of the abdominal wall blocks in current use, examining the current evidence for the efficacy and safety of each.

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“…19,23,25,40,64,65 Transversus abdominal plane block did not reduce sixhour, 19,23,25 12-hr, 19,25,40 or 24-hr pain scores 19,23,25,40,65 ( Table 2). In comparison with placebo, the effect of the TAP block on morphine consumption at 24 hr 19,23,25,40 was also not significant (-14.2 mg; 95% CI, -30.6 to 2.2; P = 0.09)…”

Section: Transversus Abdominal Plane Block In Urologic Surgerymentioning

confidence: 99%

“…16,29,36,38,[40][41][42][43]52 Compared with the control group, TAP block showed no difference in reducing the six-hour pain score 16,29,36,38,41,43 (-0.1; 95% CI, -1.4 to 1.3; P = 0.95), 12-hr pain score 16,38,41,52 (1.9, 95% CI, -4.2 to 0.4; P = 0.11), 24-hr pain score 16,29,36,38,[41][42][43]52 (-0.8; 95% CI, -2.0 to 0.4; P = 0.18), or 24-hr morphine consumption 16,29,36,38,43,52 (-14.7 mg; 95% CI, -37.8 to 8.4; P = 0.21) ( Table 2). Only one trial 16 performed TAP block from inside the abdominal wall; consequently, it was not possible to perform subgroup analysis for this comparison.…”

Section: Transversus Abdominal Plane Block In Abdominal Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

133

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Purpose The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. Source We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i.e., placebo, epidural analgesia, intrathecal morphine (ITM), and ilioinguinal nerve block after abdominal surgery]. Meta-analyses were performed on postoperative pain scores at rest at six, 12, and 24 hr (visual analogue scale, 0-10) and on 24-hr opioid consumption. Principal findings In the 51 trials identified, compared with placebo, TAP block reduced the VAS for pain at six hours by 1.4 (95% confidence interval [CI], -1.9 to -0.8; P\0.001), at 12 hr by 2.0 (95% CI, -2.7 to -1.4; P\0.001), and at 24 hr by 1.2 (95% CI, -1.6 to -0.8; P \ 0.001). Similarly, compared with placebo, TAP block reduced morphine consumption at 24 hr after surgery (mean difference, -14.7 mg; 95% CI, -18.4 to -11.0; P \0.001). We observed this reduction in pain scores and morphine consumption in the TAP block group after gynecological surgery, appendectomy, inguinal surgery, bariatric surgery, and urological surgery. Nevertheless, separate analysis of the studies comparing ITM with TAP block revealed that ITM seemed to have a greater analgesic efficacy. Conclusions The TAP block can play an important role in the management of pain after abdominal surgery by reducing both pain scores and 24-hr morphine consumption. It may have particular utility when neuraxial techniques or opioids are contraindicated. RésuméObjectif Le bloc dans le plan du muscle transverse de l'abdomen (ou TAP bloc) a été décrit comme une technique efficace de contrô le de la douleur après une chirurgie abdominale. Nous avons réalisé une revue systématique et une méta-analyse des études randomisées contrô lées (ERC) pour faire un état des lieux du nombre croissant d'études

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Efficacy of Transversus Abdominis Plane Block for Acute Postoperative Pain Relief in Kidney Recipients: A Double-Blinded Clinical Trial

Cited by 44 publications

References 14 publications

Ultrasound-guided TAP Block with or without Dexmedetomidine vs. Local Infiltration of the Wound after Open Herniorrhaphy: A Randomized Prospective Controlled Study

Ultrasound-guided TAP Block with or without Dexmedetomidine vs. Local Infiltration of the Wound after Open Herniorrhaphy: A Randomized Prospective Controlled Study

Essentials of Our Current Understanding

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

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