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

Abstract

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).