Four quadrant transversus abdominis plane block and continuous transversus abdominis plane analgesia: a 3-year prospective audit in 124 patients

Niraj, G.; Kelkar, Ashish; Hart, Elaine; Kaushik, Vipul; Fleet, Danny; Jameson, J. S.

doi:10.1016/j.jclinane.2015.07.005

Cited by 43 publications

(34 citation statements)

References 16 publications

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“…However, the effect of a single TAP block is not durable, and its analgesic efficacy lasts less than 24 h [5,8]. Thus, continuous TAP block by placing the catheter into the transverse abdominal plane and infusing local anaesthetic drugs continuously or intermittently through the catheter were used [9][10][11]. Continuous infusion of different doses of local anaesthetics in different regions of the TAP is complicated, and researchers have reported different and even conflicting outcomes compared with EA [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

The analgesic efficacy compared ultrasound-guided continuous transverse abdominis plane block with epidural analgesia following abdominal surgery: a systematic review and meta-analysis of randomized controlled trials

Qin,

Liu,

Xiong

et al. 2020

BMC Anesthesiol

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Background: This review and meta-analysis aims to evaluate the analgesic efficacy of continuous transversus abdominis plane (TAP) block compared with epidural analgesia (EA) in adults after abdominal surgery. Methods: The databases PubMed, Embase and Cochrane Central Register were searched from inception to June 2019 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy of continuous TAP block compared with EA after abdominal surgery. The weighted mean differences (WMDs) were estimates for continuous variables with a 95% confidence interval (CI) and risk ratio (RR) for dichotomous data. The pre-specified primary outcome was the dynamic pain scores 24 h postoperatively. Results: Eight trials including 453 patients (TAP block:224 patients; EA: 229 patients) ultimately met the inclusion criteria and seven trials were included in the meta-analysis. Dynamic pain scores after 24 h were equivalent between TAP block and EA groups (WMD:0.44; 95% CI: 0.1 to 0.99; I 2 = 91%; p = 0.11). The analysis showed a significant difference between the subgroups according to regularly administering (4 trials; WMD:-0.11; 95% CI: − 0.32 to 0.09; I 2 = 0%; p = 0.28) non-steroidal anti-inflammatory drugs (NSAIDs) or not (3 trials; WMD:1.02; 95% CI: 0.09 to 1.96; I 2 = 94%; p = 0.03) for adjuvant analgesics postoperatively. The measured time of the urinary catheter removal in the TAP group was significantly shorter (3 trials, WMD:-18.95, 95% CI:-25.22 to − 12.71; I 2 = 0%; p < 0.01), as was time to first ambulation postoperatively (4 trials, WMD:-6.61, 95% CI: − 13.03 to − 0.19; I 2 = 67%; p < 0.05). Conclusion: Continuous TAP block, combined with NSAIDs, can provide non-inferior dynamic analgesia efficacy compared with EA in postoperative pain management after abdominal surgery. In addition, continuous TAP block is associated with fewer postoperative side effects.

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Section: Introductionmentioning

confidence: 99%

The analgesic efficacy compared ultrasound-guided continuous transverse abdominis plane block with epidural analgesia following abdominal surgery: a systematic review and meta-analysis of randomized controlled trials

Qin,

Liu,

Xiong

et al. 2020

BMC Anesthesiol

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“…The novelty of this study is that we developed a new TAPB method to improve the success and efficacy of the procedure. The rate of TAPB failure has been reported to be approximately 10-12% [33,34], and the efficacy of TAPB remains controversial [35,36], possibly due to block failure or insufficient block range. In this study, to provide better nerve block efficacy, we administered TAPB via an amended method.…”

Section: Discussionmentioning

confidence: 99%

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

et al. 2020

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Background: Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery. Methods: A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine/ morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and offbed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded. Results: Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores. Conclusions: The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery.

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“…Our centre employs four‐quadrant TAPRSB which involves performing bilateral rectus sheath blocks as well as transversus abdominis injections, which provide analgesia to the entire anterior abdominal wall including the parietal peritoneum. This technique has been studied in patients undergoing laparoscopic CRS and has shown efficacy for postoperative analgesia . The advantage of using the above technique is expansive dermatomal coverage (T6–L1) compared with either quadratus lumborum or subcostal injection alone.…”

Section: Discussionmentioning

confidence: 99%

Comparison of preoperative versus postoperative transversus abdominis plane and rectus sheath block in patients undergoing minimally invasive colorectal surgery

et al. 2019

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Aim Ultrasound-guided transversus abdominis plane and rectus sheath block (TAPRSB) decreases pain scores and narcotic use postoperatively after colorectal surgery (CRS). It is unclear if the effectiveness of TAPRSB varies according to whether it is performed preoperatively or postoperatively. Our aim was to investigate this.Method We compared patients who underwent preoperative TAPRSB or postoperative TAPRSB during minimally invasive CRS. Primary end-points were pain scores and oral morphine milligram equivalent (MME) use postoperatively. Secondary end-points included perioperative factors affecting pain scores and postoperative MME. Summary statistics and univariate analysis by nonparametric tests were utilized. The mixed-effect model was applied to model the repeatedly measured pain score.Results From April 2015 until May 2018 168 patients received TAPRSB before (115) or after (53) minimally invasive CRS. The cohort included 79 (47.0%) women, and had an average age of 59.11 (AE12.32) years and mean body mass index of 28.32 (AE5.82) kg/m 2 . Indication for surgery was cancer in 66 (39.3%), polyp in 43 (25.6%) and diverticulitis in 43 (25.6%). Right colec-tomy was performed in 61 (36.3%), low anterior resection in 46 (27.4%) and sigmoid colectomy in 40 (23.8%) patients. The demographics of the groups were similar. Postoperative TAPRSB was only associated with lower pain scores at 12 h postoperatively. As secondary outcomes, average pain scores and MME were lower in patients who were older, had right colectomy or intracorporeal anastomosis.Conclusions Postoperative TAPRSB resulted in lower pain scores than preoperative TAPRSB 12 h after minimally invasive CRS, but otherwise no differences were seen in pain scores or MME use.Keywords Transversus abdominis block, rectus sheath block, milligram morphine equivalent, pain score, minimally invasive colorectal surgeryWhat does this study add to the literature? This study provides data regarding the timing of transversus abdominis plane and rectus sheath block and its effect on postoperative pain scores and narcotic use in patients undergoing minimally invasive colorectal surgery. It also offers more data regarding a specific type of block, which includes four injection sites.Comparison of preoperative vs postoperative transversus abdominis plane J. Xia et al.

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Four quadrant transversus abdominis plane block and continuous transversus abdominis plane analgesia: a 3-year prospective audit in 124 patients

Cited by 43 publications

References 16 publications

The analgesic efficacy compared ultrasound-guided continuous transverse abdominis plane block with epidural analgesia following abdominal surgery: a systematic review and meta-analysis of randomized controlled trials

The analgesic efficacy compared ultrasound-guided continuous transverse abdominis plane block with epidural analgesia following abdominal surgery: a systematic review and meta-analysis of randomized controlled trials

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

Comparison of preoperative versus postoperative transversus abdominis plane and rectus sheath block in patients undergoing minimally invasive colorectal surgery

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