Laparoscopic-Guided Transversus Abdominis Plane Block for Postoperative Pain Management in Minimally Invasive Surgery: Systematic Review and Meta-Analysis

Hamid, Hytham K. S.; Emile, Sameh Hany; Saber, Alan A.; Ruíz-Tóvar, Jaime; Minas, Vasileios; Cataldo, Thomas E.

doi:10.1016/j.jamcollsurg.2020.05.020

Cited by 47 publications

(25 citation statements)

References 50 publications

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“…A TAP block of 20 ml (5 ml in each quadrant of the fascia incision) of .25% bupivacaine was injected percutaneously in the pre‐peritoneal plane under direct vision with the laparoscopic camera using a 22 gauge needle in a similar fashion to that which has been previously described. 12 Another 10 ml of .25% bupivacaine was injected around the laparoscopic incisions. To maintain blinding and increase safety, patients in both the control and QL block groups received an Exparel wristband after surgery to prevent any further local anesthetic injection during the first 96 h after surgery.…”

Section: Methodsmentioning

confidence: 99%

Randomized controlled trial of a quadratus lumborum block with liposomal bupivacaine for postoperative analgesia in laparoscopic donor nephrectomy

Gritsch

Osbun

Grogan

et al. 2021

Clinical Transplantation

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Perioperative pain management is an important consideration in early recovery and patient satisfaction following laparoscopic donor nephrectomy. Transmuscular quadratus lumborum block has been described to reduce pain and opioid usage following several abdominal surgeries. In this prospective single-blind randomized controlled trial, we compared 52 patients who adhered to our institutional donor nephrectomy Early Recovery After Surgery pathway, which includes a laparoscopic-guided transversus abdominus plane block, to 40 patients who additionally received a transmuscular quadratus lumborum block with liposomal bupivacaine. Compared to control patients, those who received the block spent longer in the operating room prior to the surgical start (65.4 vs. 51.6 min, P < .001). Both groups had similar total hospital length of stay (33.3 h vs. 34.4 h, P = .61). Pain scores from postoperative days 0-30, number of patients requiring opioids, postoperative nausea, and pain management satisfaction were similar between both groups. Patients who received the block consumed less opioid on postoperative day 1 compared to controls (P = .006). No complications were attributable to the block. The quadratus lumborum block provides a safe pain management adjunct for some patients, and may reduce opioid use in the early postoperative period when combined with our standard institutional protocol for kidney donors.

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Section: Methodsmentioning

confidence: 99%

Randomized controlled trial of a quadratus lumborum block with liposomal bupivacaine for postoperative analgesia in laparoscopic donor nephrectomy

Gritsch

Osbun

Grogan

et al. 2021

Clinical Transplantation

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“…Furthermore, the results of our study are supported by a large systematic review, which included nearly 2,000 patients across 19 randomized controlled trials, comparing laparoscopic-assisted TAP with ultrasound-guided TAP block, local infiltration analgesia, or inactive control. 2 Laparoscopic-assisted TAP was comparable to ultrasoundguided TAP block and superior to local analgesia, in recovery parameters, 24-hour opioid consumption, and postoperative nausea and vomiting. 2 This data, along with results from our prior study, support the continued use of laparoscopic-assisted TAP block for reduced postoperative pain and narcotic usage.…”

mentioning

confidence: 87%

“…2 Laparoscopic-assisted TAP was comparable to ultrasoundguided TAP block and superior to local analgesia, in recovery parameters, 24-hour opioid consumption, and postoperative nausea and vomiting. 2 This data, along with results from our prior study, support the continued use of laparoscopic-assisted TAP block for reduced postoperative pain and narcotic usage.…”

mentioning

confidence: 87%

Response to Letter to the Editor: Laparoscopic Posterior Versus Lateral Transversus Abdominis Plane Block in Gynecology

Benabou¹,

Seifi²

2021

JSLS

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We would like to thank Austin et al. for their comments regarding our recent manuscript. 1 The authors of the letter raised concern over the use of "Doyle's internal bulge sign" as a visual indicator of correct placement of transversus abdominis plane (TAP) block during laparoscopy. Austin et al. described an interesting study performed on 24 patients, who received laparoscopic-assisted TAP block followed by ultrasonographic evaluation. The authors reported correct placement of laparoscopicassisted TAP block, as determined by ultrasonographic findings, in approximately half of patients. However, the authors did not mention patient characteristics or whether there were any differences in postoperative pain and pain medication usage in their study.

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“…Laparoscopically inserted transversus abdominis plane block (LTAP) is a novel technique that has been used by gastrointestinal surgeons, especially in laparoscopic cholecystectomies and colorectal surgery [ 7 , 8 ] with equally good results in comparison to UTAP [ 9 ]. According to a recent meta-analysis, LTAP is safe and superior to local wound analgesia in adults undergoing minimally invasive surgery (such as laparoscopic or robotic abdominal procedures) regarding early pain control, opioid consumption, and patient satisfaction [ 10 ]. In another study, a reduction in postoperative pain score measured by visual analog scale was noted even at 1 week after laparoscopic cholecystectomy with LTAP in comparison to local wound analgesia [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopically guided transversus abdominis plane block versus local wound analgesia in laparoscopic surgery for peritoneal endometriosis: study protocol for a prospective randomized controlled double-blinded LTAP-trial

Terho

Puhto

Laru

et al. 2022

Trials

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Background Ultrasound-guided transversus abdominis plane block (TAP) performed by anesthesiologist has been shown to be an effective and safe analgesia method in abdominal surgery, reducing postoperative opioid consumption. Recently, there has been growing interest to insert TAP under laparoscopic vision (LTAP) by surgeon. LTAP has been used in laparoscopic gastrointestinal surgery, but studies on LTAP in gynecologic laparoscopic surgery are sparse and inconsistent. The purpose of this study is to compare the efficacy of LTAP and local wound analgesia in laparoscopic surgery due to suspected or diagnosed superficial peritoneal endometriosis. Methods The LTAP-trial is a prospective randomized controlled double-blinded study comparing the efficacy and safety of LTAP with local wound analgesia in laparoscopic endometriosis surgery. Patients are randomized to receive LTAP with levobupivacaine and wound infiltration with placebo or wound infiltration with levobupivacaine and LTAP with placebo. The primary outcome is postoperative opioid consumption measured by patient-controlled analgesia (PCA) pump. Secondly, subjective postoperative pain up to 24 h postoperatively will be measured by Numeric Rating Scale (NRS). Additional outcome measures are factors related to recovery and length of stay in the hospital as well as a 6-month follow-up survey regarding pain (NRS) and endometriosis-related wellbeing (endometriosis-related health profile, EHP-30) after surgery. A total of 46 patients will be randomized in a proportion of 1:1. Discussion Patients with peritoneal endometriosis are often prone to severe postoperative pain that may prohibit their enhanced recovery after laparoscopy. Thus, there is a need for effective postoperative pain management with minimal side-effects. This study focusing on laparoscopically inserted transversus abdominis plane block may provide new insight in dealing with postoperative pain after laparoscopic endometriosis surgery as well as after other gynecologic surgery. Trial registration The LTAP-trial -protocol has been prospectively registered to ClinicalTrials.gov, ID: NCT04735770. Registered on February 2021.

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Laparoscopic-Guided Transversus Abdominis Plane Block for Postoperative Pain Management in Minimally Invasive Surgery: Systematic Review and Meta-Analysis

Cited by 47 publications

References 50 publications

Randomized controlled trial of a quadratus lumborum block with liposomal bupivacaine for postoperative analgesia in laparoscopic donor nephrectomy

Randomized controlled trial of a quadratus lumborum block with liposomal bupivacaine for postoperative analgesia in laparoscopic donor nephrectomy

Response to Letter to the Editor: Laparoscopic Posterior Versus Lateral Transversus Abdominis Plane Block in Gynecology

Laparoscopically guided transversus abdominis plane block versus local wound analgesia in laparoscopic surgery for peritoneal endometriosis: study protocol for a prospective randomized controlled double-blinded LTAP-trial

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