Transversus Abdominis Plane Block Anesthesia in Abdominoplasties

Sforza, Marcos; Andjelkov, Katarina; Zaccheddu, Renato; Nagi, H.; Čolić, Miodrag

doi:10.1097/prs.0b013e31821e6f51

Cited by 70 publications

(78 citation statements)

References 11 publications

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“…In three studies, the injection of local anesthetic into the TAP was performed from inside the abdominal wall. [16][17][18] The remaining 12 studies used a non-US-guided loss-ofresistance technique. Tables 2 and 3 provide a summary of the statistical analysis (i.e., mean VAS differences, CI, P value, heterogeneity scores, and quality of the evidence [GRADE]) for each of the subcategories of TAP block use described below.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

133

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Purpose The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. Source We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i.e., placebo, epidural analgesia, intrathecal morphine (ITM), and ilioinguinal nerve block after abdominal surgery]. Meta-analyses were performed on postoperative pain scores at rest at six, 12, and 24 hr (visual analogue scale, 0-10) and on 24-hr opioid consumption. Principal findings In the 51 trials identified, compared with placebo, TAP block reduced the VAS for pain at six hours by 1.4 (95% confidence interval [CI], -1.9 to -0.8; P\0.001), at 12 hr by 2.0 (95% CI, -2.7 to -1.4; P\0.001), and at 24 hr by 1.2 (95% CI, -1.6 to -0.8; P \ 0.001). Similarly, compared with placebo, TAP block reduced morphine consumption at 24 hr after surgery (mean difference, -14.7 mg; 95% CI, -18.4 to -11.0; P \0.001). We observed this reduction in pain scores and morphine consumption in the TAP block group after gynecological surgery, appendectomy, inguinal surgery, bariatric surgery, and urological surgery. Nevertheless, separate analysis of the studies comparing ITM with TAP block revealed that ITM seemed to have a greater analgesic efficacy. Conclusions The TAP block can play an important role in the management of pain after abdominal surgery by reducing both pain scores and 24-hr morphine consumption. It may have particular utility when neuraxial techniques or opioids are contraindicated. RésuméObjectif Le bloc dans le plan du muscle transverse de l'abdomen (ou TAP bloc) a été décrit comme une technique efficace de contrô le de la douleur après une chirurgie abdominale. Nous avons réalisé une revue systématique et une méta-analyse des études randomisées contrô lées (ERC) pour faire un état des lieux du nombre croissant d'études

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Section: Resultsmentioning

confidence: 99%

“…Pain scores at six and 12 hr were investigated in 23 and 18 [16][17][18][19][20][21][22][23]25,26,29,31,32,[34][35][36][38][39][40][41] studies, respectively. The overall analyses showed that, in the TAP block group, the six-hour VAS pain score was reduced by 1.4 (95% CI, -1.9 to -0.8; P \ 0.001) (Fig.…”

Section: Transversus Abdominal Plane Block Vs Placebomentioning

confidence: 99%

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

133

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“…However, the study was limited in that efforts to obtain subjective pain scores from a patient in the immediate recovery period were often impaired by the systemic effects of general anesthesia. Sforza et al 9 also used a similar technique in placing a specific anesthetic block in the transversus abdominis plane. This study was also limited to the immediate postoperative recovery period; more important, that nerve block technique is much more difficult to perform, and there is a significant risk of inadvertent peritoneal puncture.…”

Section: Discussionmentioning

confidence: 99%

Use of Abdominal Field Block Injections With Liposomal Bupivicaine to Control Postoperative Pain After Abdominoplasty

Morales¹,

Mentz²,

Newall³

et al. 2013

Aesthetic Surgery Journal

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“…Peripheral nerve blocks - specifically transversus abdominis plane (TAP) blocks - have been described [18-20]. A modification of the TAP technique which involves surgeon placement of the TAP catheters directly into the open surgical wound (medial open transversus abdominis plane; MOTAP) has been investigated both at Sunnybrook Health Sciences Centre and at the University Health Network – Toronto General Division [21].…”

Section: Introductionmentioning

confidence: 99%

Medial open transversus abdominis plane (MOTAP) catheters for analgesia following open liver resection: study protocol for a randomized controlled trial

Karanicolas

Cleary

McHardy

et al. 2014

Trials

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BackgroundThe current standard for pain control following liver surgery is intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. We have developed a modification of a regional technique called medial open transversus abdominis plane (MOTAP) catheter analgesia. The MOTAP technique involves surgically placed catheters through the open surgical site into a plane between the internal oblique muscle and the transverse abdominis muscle superiorly. The objective of this trial is to assess the efficacy of this technique.Methods/designThis protocol describes a multicentre, prospective, blinded, randomized controlled trial. One hundred and twenty patients scheduled for open liver resection through a subcostal incision will be enrolled. All patients will have two MOTAP catheters placed at the conclusion of surgery. Patients will be randomized to one of two parallel groups: experimental (local anaesthetic through MOTAP catheters) or placebo (normal saline through MOTAP catheters). Both groups will also receive IV PCA. The primary endpoint is mean cumulative postoperative opioid consumption over the first 2 postoperative days (48 hours). Secondary outcomes include pain intensity, patient functional outcomes, and the incidence of complications.DiscussionThis trial has been approved by the ethics boards at participating centres and is currently enrolling patients. Data collection will be completed by the end of 2014 with analysis mid-2015 and publication by the end of 2015.Trial registrationThe study is registered with http://clinicaltrials.gov ( NCT01960049; 23 September 2013)

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Transversus Abdominis Plane Block Anesthesia in Abdominoplasties

Abstract: Therapeutic, II.

Cited by 70 publications

References 11 publications

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Use of Abdominal Field Block Injections With Liposomal Bupivicaine to Control Postoperative Pain After Abdominoplasty

Medial open transversus abdominis plane (MOTAP) catheters for analgesia following open liver resection: study protocol for a randomized controlled trial

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