The effect of ultrasound-guided transversus abdominis plane block on pulmonary function in patients undergoing laparoscopic cholecystectomy: a prospective randomized study

Lee, Seung Young; Ryu, Choongun; Koo, Young Hyun; Cho, Hanna; Jung, Haesun; Park, Yong‐Hee; Kang, Hyun; Shin, Hwa Yong

doi:10.1007/s00464-022-09131-y

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…Adherence Rate. Adverse Events Rate Lee SY (2022) [ 32 ] Korea 20–70 I-II 40 ml of 0.375% ropivacaine saline Postoperative PREMEDICATION: none, INDUCTION: lidocaine (0.5 mg/kg), PRP (2 mg/ kg), REM (0.5 mcg/kg), and ROC (0.6 mg/kg), MAINTENANCE: oxygen (fraction of inspired oxygen, 0.5), SEVO (2–3%), and REM infusion (0.1 mcg/kg/min) continuously infuse 0.2 mcg/kg of FNT every hour, and the bolus dose was 0.2 mcg/kg with a 15-min lockout time Postoperative Pulmonary Function And Analgesia Jung J (2021) [ 33 ] Korea 20–60 I-III 0.25% ropivacaine saline Preoperative INDUCTION: PRP 4–6 μg/mL and REM 2–6 μg/mL, ROC 0.6–1.0 mg/kg, MAINTENANCE: PRP, REM PACU: NRS score was > 3, the nurse injected 3-mg IV oxycodone; at ward,30 mg IV ketorolac/8 h at POD0; From POD 1, per-os 50 mg tramadol was administered every 8 hours Quality Of Recovery Baral B (2018) [ 34 ] Nepal 18–60 I-II 20 ml of 0.25% Bupivacaine 20 ml of 0.25% Bupivacaine Postoperative induction: FNT (2 mcg/kg), PRP (2 mg/kg), and vecuronium (0.8 mg/kg), MAINTENANCE: oxygen, isoflurane, intermittent dose of vecuronium Paracetamol 1 g 6 hourly; VAS ≥4 pethidine 0.5 mg/kg Postoperative Pain Basaran B (2015) [ 35 ] Turkey 18–65 I-II bupivacaine 0.25% 20 ml – Preoperative PREMEDICATION: MDZ 0.03 mg/kg INDUCTION: FNT 1 μg/kg, MDZ 0.15 mg/kg, PRP 1–2 mg/kg, ROC 1 mg/kg. MAINTENANCE: SEVO, ROC infusion (0.01 mg/kg/min) and FNT (2–3 μg/kg/h).…”

Section: Resultsmentioning

confidence: 99%

“…In total, 22 of the included studies compared pre-operative TAP block with a control [ 22 , 23 , 25 , 27 – 29 , 31 , 33 , 35 – 43 , 45 , 46 , 49 , 52 , 54 ], 11 evaluated the effect of postoperative TAP block compared with a control block [ 24 , 26 , 30 , 32 , 34 , 44 , 47 , 48 , 50 , 51 , 53 ], and only one directly compared pre-operative TAP block with postoperative TAP block [ 11 ]. A total of 2317 patients were enrolled in the included trials: 456 patients were randomised to the postoperative TAP block group, 773 to the pre-operative TAP block group, and the remaining to the control group.…”

Section: Resultsmentioning

confidence: 99%

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Analgesic benefits of pre-operative versus postoperative transversus abdominis plane block for laparoscopic cholecystectomy: a frequentist network meta-analysis of randomized controlled trials

Dost,

De Cassai,

Balzani

et al. 2023

BMC Anesthesiol

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Background Transversus abdominis plane (TAP) block has been utilized to alleviate pain following laparoscopic cholecystectomy (LC). However, the optimal timing of administration remains uncertain. This study aimed to compare the efficacy of pre-operative and postoperative TAP blocks as analgesic options after LC. Methods A frequentist network meta-analysis of randomized controlled trials (RCTs) was conducted. We systematically searched PubMed (via the National Library of Medicine), EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science up to March 2023. The study included RCTs that enrolled adult patients (≥ 18 years) who underwent LC and received either pre-operative or postoperative TAP blocks. The primary outcome assessed was 24-hour postoperative morphine consumption (mg). Additionally, pain rest scores within 3 hours, 12 hours, and 24 hours, as well as postoperative nausea and vomiting (PONV), were considered as pre-specified secondary outcomes. Results A total of 34 trials with 2317 patients were included in the analysis. Postoperative TAP block demonstrated superiority over the pre-operative TAP block in reducing opioid consumption (MD 2.02, 95% CI 0.87 to 3.18, I2 98.6%, p < 0.001). However, with regards to postoperative pain, neither pre-operative nor postoperative TAP blocks exhibited superiority over each other at any of the assessed time points. The postoperative TAP block consistently ranked as the best intervention using SUCRA analysis. Moreover, the postoperative TAP block led to the most significant reduction in PONV. Conclusions The findings suggest that the postoperative TAP block may be slightly more effective in reducing 24-hour postoperative opioid consumption and PONV when compared to the pre-operative TAP block. Trial registration PROSPERO, CRD42023396880.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Analgesic benefits of pre-operative versus postoperative transversus abdominis plane block for laparoscopic cholecystectomy: a frequentist network meta-analysis of randomized controlled trials

Dost,

De Cassai,

Balzani

et al. 2023

BMC Anesthesiol

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Pain management after laparoscopic cholecystectomy

Bourgeois,

Oyaert,

Van de Velde

et al. 2024

European Journal of Anaesthesiology

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Laparoscopic cholecystectomy can be associated with significant postoperative pain that is difficult to treat. We aimed to evaluate the available literature and develop updated recommendations for optimal pain management after laparoscopic cholecystectomy. A systematic review was performed using the procedure-specific postoperative pain management (PROSPECT) methodology. Randomised controlled trials and systematic reviews published in the English language from August 2017 to December 2022 assessing postoperative pain after laparoscopic cholecystectomy using analgesic, anaesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane Databases. From 589 full text articles, 157 randomised controlled trials and 31 systematic reviews met the inclusion criteria. Paracetamol combined with NSAIDs or cyclo-oxygenase-2 inhibitors should be given either pre-operatively or intra-operatively, unless contraindicated. In addition, intra-operative intravenous (i.v.) dexamethasone, port-site wound infiltration or intraperitoneal local anaesthetic instillation are recommended, with opioids used for rescue analgesia. As a second-line regional technique, the erector spinae plane block or transversus abdominis plane block may be reserved for patients with a heightened risk of postoperative pain. Three-port laparoscopy, a low-pressure pneumoperitoneum, umbilical port extraction, active aspiration of the pneumoperitoneum and saline irrigation are recommended technical aspects of the operative procedure. The following interventions are not recommended due to limited or no evidence on improved pain scores: single port or mini-port techniques, routine drainage, low flow insufflation, natural orifice transluminal endoscopic surgery (NOTES), infra-umbilical incision, i.v. clonidine, nefopam and regional techniques such as quadratus lumborum block or rectus sheath block. Several interventions provided better pain scores but are not recommended due to risk of side effects: spinal or epidural anaesthesia, gabapentinoids, i.v. lidocaine, i.v. ketamine and i.v. dexmedetomidine.

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Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

Alsharari

Abuadas

Alnassrallah

et al. 2022

JCM

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Laparoscopic cholecystectomy (LC), unlike laparotomy, is an invasive surgical procedure, and some patients report mild to moderate pain after surgery. Transversus abdominis plane (TAP) block has been shown to be an appropriate method for postoperative analgesia in patients undergoing abdominal surgery. However, there have been few studies on the efficacy of TAP block after LC surgery, with unclear information on the optimal dose, long-term effects, and clinical significance, and the analgesic efficacy of various procedures, hence the need for this review. Five electronic databases (PubMed, Academic Search Premier, Web of Science, CINAHL, and Cochrane Library) were searched for eligible studies published from inception to the present. Post-mean and standard deviation values for pain assessed were extracted, and mean changes per group were calculated. Clinical significance was determined using the distribution-based approach. Four different local anesthetics (Bupivacaine, Ropivacaine, Lidocaine, and Levobupivacaine) were used at varying concentrations from 0.2% to 0.375%. Ten different drug solutions (i.e., esmolol, Dexamethasone, Magnesium Sulfate, Ketorolac, Oxycodone, Epinephrine, Sufentanil, Tropisetron, normal saline, and Dexmedetomidine) were used as adjuvants. The optimal dose of local anesthetics for LC could be 20 mL with 0.4 mL/kg for port infiltration. Various TAP procedures such as ultrasound-guided transversus abdominis plane (US-TAP) block and other strategies have been shown to be used for pain management in LC; however, TAP blockade procedures were reported to be the most effective method for analgesia compared with general anesthesia and port infiltration. Instead of 0.25% Bupivacaine, 1% Pethidine could be used for the TAP block procedures. Multimodal analgesia could be another strategy for pain management. Analgesia with TAP blockade decreases opioid consumption significantly and provides effective analgesia. Further studies should identify the long-term effects of different TAP block procedures.

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The effect of ultrasound-guided transversus abdominis plane block on pulmonary function in patients undergoing laparoscopic cholecystectomy: a prospective randomized study

Cited by 4 publications

References 25 publications

Analgesic benefits of pre-operative versus postoperative transversus abdominis plane block for laparoscopic cholecystectomy: a frequentist network meta-analysis of randomized controlled trials

Analgesic benefits of pre-operative versus postoperative transversus abdominis plane block for laparoscopic cholecystectomy: a frequentist network meta-analysis of randomized controlled trials

Pain management after laparoscopic cholecystectomy

Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

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