Laparoscopically guided transversus abdominis plane block offers better pain relief after laparoscopic cholecystectomy: results of a triple blind randomized controlled trial

Vindal, Anubhav; Sarda, Hitesh; Lal, Pawanindra

doi:10.1007/s00464-020-07558-9

Cited by 23 publications

(18 citation statements)

References 12 publications

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“…TAPB relieves pain after abdominal surgery by blocking the sensory nerve of the anterolateral abdominal wall (T6-L1) [ 12 ]. A large number of studies have confirmed that TAPB can provide safe and effective postoperative analgesia for patients undergoing a variety of abdominal surgeries, including laparoscopic cholecystectomies [ 13 ], hysterectomies [ 14 ], and gastrointestinal surgeries [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

et al. 2021

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Introduction: Postoperative analgesia in elderly patients is still a thorny problem. Ultrasoundguided oblique subcostal transverse abdominis plane block (TAPB) has been demonstrated to provide postoperative analgesia after abdominal surgeries. However, recent studies have suggested that an alternative method, erector spinae plane block (ESPB), might also be effective. In this study, we compared the postoperative analgesic effects of ESPB and TAPB in elderly patients who had undergone laparoscopic colorectal surgery. Methods: Sixty-two elderly patients (C 65 years old) scheduled for elective laparoscopic colorectal surgery with general anesthesia were randomly allocated to two equally sized groups: ESPB group and TAPB group. The ESPB group had a bilateral erector spinae plane block, and the TAPB group had a bilateral oblique subcostal transverse abdominis plane block. The primary outcome was visual analogue scale (VAS) pain score during the first 24 postoperative hours at resting and active states. The secondary outcomes were postoperative consumption of sufentanil, satisfaction score, the number of patients who required antiemetics, incidence of block-related complications, and other side events. Results: There were no demographic differences between two groups. Compared to the TAPB group, the ESPB group had lower VAS pain scores and sufentanil consumption during the first 24 postoperative hours. Additionally, ESPB reduced the occurrence of postoperative nausea and vomiting. Furthermore, the satisfaction score was higher in the ESPB group. No other complications were reported between the two groups. Conclusions: Compared with oblique subcostal TAPB, ESPB more effectively reduced postoperative pain and opioid consumption. Thus, ESPB is suitable for postoperative analgesia in elderly patients who have undergone laparoscopic colorectal surgery.

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Section: Introductionmentioning

confidence: 99%

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

et al. 2021

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“…VAS score at coughing was also reduced at all times in the LG TAP block. [ 3 ] The total consumption of morphine was significantly less in group U than group L. Peng et al . in their meta-analysis concluded that TAP block reduced the consumption of opioids and thereby its associated adverse effects.…”

Section: Discussionmentioning

confidence: 96%

“…The use of laparoscopy in performing subcostal TAP block is grossly underutilised and few studies have documented the efficacy of LG subcostal TAP block. [ 3 12 13 ] LG TAP block has been proven to be effective in providing postoperative pain relief for other laparoscopic surgeries like colorectal surgery,[ 14 ] gynaecological laparoscopy,[ 15 ] and robotic-assisted gynaecologic surgery. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] The correct plane of infiltration in the LG subcostal TAP block was identified by visualising the lifting of fibres of transversus abdominis muscle (Doyle's bulge) seen intra-peritoneally by hydrodissection and has been depicted in Figure 1 . [ 3 ] Group L patients also received 20 mL of 0.2% ropivacaine and 8 mg dexamethasone. All the patients received paracetamol 1 g at the end of surgery and every 6 h intravenously for 24 h. The patients did not receive any other additional analgesics.…”

Section: Methodsmentioning

confidence: 99%

“…Laparoscopy can be utilised as a guide to performing subcostal TAP block where ultrasound or technical expertise to operate it is not available. [ 3 ]…”

Section: Introductionmentioning

confidence: 99%

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Comparison of laparoscopy-guided with ultrasound-guided subcostal transversus abdominis plane block in laparoscopic cholecystectomy – A prospective, randomised study

et al. 2020

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Background and Aims: Subcostal transversus abdominis plane (TAP) block is usually done under ultrasound guidance in laparoscopic cholecystectomy. Laparoscopic-guided subcostal TAP block is an alternate technique where ultrasound is not available. Our primary objective was to compare the success rate of ultrasound and laparoscopic approaches to the subcostal TAP block. The secondary objectives were to assess the duration of postoperative analgesia and morphine consumption postoperatively for 24 h. Methods: Eighty patients undergoing laparoscopic cholecystectomy were randomly divided into two groups with patients receiving ultrasound-guided (group U) or laparoscopy-guided (group L) subcostal TAP block at the end of surgery. The success rate was assessed by a sensory blockade of T7 and T8 dermatomes 30 min after extubation. The duration of analgesia was taken as time from block administration to the visual analogue scale of ≥3. Morphine was administered in patient-controlled analgesia (PCA) pump with a bolus of 1 mg and a lock-out interval of 10 min. The total morphine consumption was recorded. The statistical analysis was performed with student t -test and Chi-square test. Results: The success rate of group U (100%) was higher than group L (88%) but it was not statistically significant ( P = 0.054). The duration of postoperative analgesia was significantly prolonged in group U (867.24 ± 135.83 min) than group L (751.31 ± 311.22 min) ( P = 0.033). Morphine consumption was also less in group U (4.72 ± 0.94 mg) than group L (5.57 ± 2.53 mg) ( P = 0.049). There was no significant difference in the VAS scores after 4 h postoperatively. Conclusion: Laparoscopy-guided subcostal TAP block is a suitable alternative to ultrasound-guided block and can be utilised in places where an ultrasound machine is not available.

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Laparoscopic-guided distal loco-regional anesthetic infiltration technique in TAPP inguinal hernia repair: a double-blind randomized clinical trial

et al. 2021

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Laparoscopically guided transversus abdominis plane block offers better pain relief after laparoscopic cholecystectomy: results of a triple blind randomized controlled trial

Cited by 23 publications

References 12 publications

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

Comparison of laparoscopy-guided with ultrasound-guided subcostal transversus abdominis plane block in laparoscopic cholecystectomy – A prospective, randomised study

Laparoscopic-guided distal loco-regional anesthetic infiltration technique in TAPP inguinal hernia repair: a double-blind randomized clinical trial

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