The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy

Ömür, Dilek; Oğuzalp, Hüseyin; Kiraz, Hasan Ali; Ekin, Serpil; Crozier, Alan; Ersay, Ahmet Reşit; Hancı, Volkan

doi:10.15537/smj.2016.6.14332

Cited by 7 publications

(23 citation statements)

References 26 publications

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“…1). Review of the full text of the remaining 40 articles resulted in the exclusion of a further 20 studies, leaving a total of 20 RCTs for final analysis 21–40 …”

Section: Resultsmentioning

confidence: 99%

“…A total of 17 studies compared TAP blocks with placebo or no treatment 21–24,26,27,29–39 . Three studies additionally investigated either the effects of local anaesthetic wound infiltration, 25 intravenous lignocaine 28 or dexmedetomidine as an adjuvant to the local anaesthetic 40 .…”

Section: Resultsmentioning

confidence: 99%

“…In one study, the block was introduced before the induction of anaesthesia, 29 whereas in the remaining 19 it was performed after anaesthetic induction but before endotracheal extubation. In 14 out of those 19 studies the block was inserted before skin incision, 22–24,27,28,32–40 in one a catheter was inserted on wound closure 31 and in the remaining four studies the block was performed after skin closure 21,25,26,30 …”

Section: Resultsmentioning

confidence: 99%

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Transversus abdominis plane block in urological procedures

Zayed

Allers

Hoffmann

et al. 2021

European Journal of Anaesthesiology

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BACKGROUND Transversus abdominis plane (TAP) blocks have been shown to successfully reduce pain and opioid consumption after general and gynaecological surgery. OBJECTIVE To evaluate whether TAP blocks alleviate pain and opioid consumption after urological procedures. DESIGN A systematic review and meta-analysis. DATA SOURCES MEDLINE, Embase and CENTRAL. ELIGIBILITY CRITERIA Without language restriction, randomised controlled trials (RCTs) that compared the effects of TAP blocks with placebo or no treatment in urological surgery. MAIN OUTCOME MEASURES Primary outcomes were pain intensities at rest and movement at 6, 12 and 24 h after surgery. Secondary outcomes were postoperative opioid consumption in the first 24 h after surgery and postoperative nausea and vomiting. We performed meta-analyses using random effects models. Effect sizes were expressed as mean differences for continuous variables. We used the Cochrane risk of bias tool (RoB 2.0) to assess risk of bias. RESULTS We analysed 20 RCTs comprising a total of 1239 patients. The risk of bias of the studies was relatively high. TAP blocks significantly reduced postoperative pain at all time points compared with placebo or no treatment. Mean differences on an 11-point pain intensity scale were between 0.55 (95% CI: −0.90, to −0.21; P = 0.002; I 2 = 94%) to 1.13 (95% CI: −1.62 to −0.65; P < 0.001; I 2 = 95%) less at rest and 0.74 (95% CI: −1.25 to −0.23; P = 0.005; I 2 = 79%) to 1.32 (95% CI: −1.83 to −0.81; P < 0.001; I 2 = 68%) less on movements. TAP blocks also reduced opioid consumption in the first 24 h after surgery significantly by 12.25 mg (95% CI: −17.99 to −6.52 mg; P < 0.001; I 2 = 99%) morphine equivalents. Possibly, this had no influence on postoperative nausea and vomiting (risk ratio: 0.98; 95% CI: 0.66 to 1.45; P = 0.91; I 2 = 30%). CONCLUSION TAP blocks seem to offer improved analgesia when used after urological surgery. However, due to the large heterogeneity between and the considerable risk of bias within the included studies results should be viewed with caution. SYSTEMIC REVIEW REGISTRATION PROSPERO CRD42018112737.

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“…1). Review of the full text of the remaining 40 articles resulted in the exclusion of a further 20 studies, leaving a total of 20 RCTs for final analysis 21–40 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Transversus abdominis plane block in urological procedures

Zayed

Allers

Hoffmann

et al. 2021

European Journal of Anaesthesiology

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“…Most of the previous studies administered morphine for postoperative analgesia. [5,13,18] We administered tramadol because it is routinely used for postoperative analgesia in our institute, and was also devoid of remarkable respiratory depression, sedation, and dependence. [19] Tramadol has a higher incidence of nausea and vomiting than morphine.…”

Section: Discussionmentioning

confidence: 99%

The analgesic efficacy of oblique subcostal transversus abdominis plane block after laparoscopic hysterectomy

et al. 2019

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Background:We aimed to assess whether an ultrasound (US)-guided oblique subcostal transversus abdominis plane (OSTAP) block would improve the postoperative pain scores and decrease the tramadol consumption after a laparoscopic hysterectomy.Methods:Sixty-six female patients with American Society of Anesthesiologists I, II, or III, aged 18 to 65 years who were scheduled for laparoscopic hysterectomy for benign gynecologic pathologies were recruited in this randomized, controlled, observer-blinded trial. Sixty patients completed the study. Patients were randomized into 2 groups. In the OSTAP group, the patients received a bilateral OSTAP block with 40 mL of 0.375% bupivacaine and in the Sham group received an US-guided bilateral OSTAP with 40 mL of 0.9% saline. All patients received tramadol patient-controlled analgesia for the first 24th hour. Patients in the Sham group received an US-guided bilateral OSTAP with 40 mL of 0.9% saline. The primary outcome was the 24th hour tramadol consumption. The secondary outcomes included visual analog scale (VAS) scores during movement, the tramadol consumption at the 1st, 4th, and 12th postoperative hours, and nausea scores at the 24th hour postoperatively.Results:At all time points, tramadol consumption of the OSTAP group remained significantly lower when compared with Sham group. The OSTAP group showed a statistically significant reduction at the postoperative 24th hour tramadol consumption (mean difference 22 mg, 95% confidence interval −38.4 to −5.6 mL; P = .009). Compared with the Sham group, OSTAP block reduced the VAS scores at all time points during movement. Nausea scores at the 24th postoperative hour were significantly lower in the OSTAP group compared with the Sham groupConclusion:We concluded that bilateral US-guided OSTAP blocks reduced 24th hour tramadol requirements and VAS scores after laparoscopic hysterectomy. The OSTAP block is a promising technique for producing effective and prolonged postoperative analgesia in patients undergoing laparoscopic hysterectomy surgeries.

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“…Although the conventional method of anesthesia is effective, the post-operative risk of nausea, vomiting, opioids effects, urinary retention is usually inevitable. Several studies done say transverse abdominis plane block (TAPB) provides a good intraoperative and acute pain relief which also results in decrease in use of opioids resulting less opioids related complications, compared with anesthetic techniques like intravenous and spinal/epidural anesthesia with less compli-cations [5] [6] [7] [8] [9]. However, there has been less research on the relationship between CPOP and TAPB.…”

Section: Introductionmentioning

confidence: 99%

Effect of Transverse Abdominis Plane Block on Chronic Post-Operative Pain—A Review

Lamichhane¹,

Yang²,

Ma³

2017

OJAnes

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Chronic post-operative pain is a recognized adverse consequence of surgery; managing and preventing it are always a better choice. Proper choice of Anesthetic technique, use of combined anesthesia and pre-emptive analgesia may prevent and decrease the incidence of chronic post-operative pain. Transverse abdominis plane block (TAP Block) is a regional anesthesia technique following abdominal surgeries which involve injection of a large amount of local anesthetics in TAP, an anatomical space between the internal oblique and transverse abdominis muscle. The aim of this review is to show the effect and uses of TAP block as a combined anesthesia and multimodal analgesia in preventing chronic post-operative pain.

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The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy

Cited by 7 publications

References 26 publications

Transversus abdominis plane block in urological procedures

Transversus abdominis plane block in urological procedures

The analgesic efficacy of oblique subcostal transversus abdominis plane block after laparoscopic hysterectomy

Effect of Transverse Abdominis Plane Block on Chronic Post-Operative Pain—A Review

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