Transversus abdominis plane block for renal transplant recipients

Mukhtar, Karim; Khattak, Ilyas

doi:10.1093/bja/aeq077

Cited by 48 publications

(32 citation statements)

References 11 publications

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“…Our finding of preincisional TAP block reducing intraoperative fentanyl requirement was consistent with those of Mukhtar and Khattak[14] who reported a significant reduction in intraoperative morphine consumption in patients receiving TAP block with 0.5% bupivacaine in renal transplant recipients (0.4 ± 1.2 mg vs. 9.3 ± 1.4 mg; P < 0.0001). El-Dawlatly et al .…”

Section: Discussionsupporting

confidence: 91%

Analgesic efficacy of transversus abdominis plane block in providing effective perioperative analgesia in patients undergoing total abdominal hysterectomy: A randomized controlled trial

Bhattacharjee

Ray

Ghose

et al. 2014

J Anaesthesiol Clin Pharmacol

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Background and Aims:Transversus abdominis plane (TAP) block has been shown to provide postoperative pain relief following various abdominal and inguinal surgeries, but few studies have evaluated its analgesic efficacy for intraoperative analgesia. We evaluated the efficacy of TAP block in providing effective perioperative analgesia in total abdominal hysterectomy in a randomized double-blind controlled clinical trial.Materials and Methods:A total of 90 adult female patients American Society of Anesthesiologists physical status I or II were randomized to Group B (n = 45) receiving TAP block with 0.25% bupivacaine and Group N (n = 45) with normal saline followed by general anesthesia. Hemodynamic responses to surgical incision and intraoperative fentanyl consumption were noted. Visual analog scale (VAS) scores were assessed on the emergence, at 1, 2, 3, 4, 5, 6 and 24 h. Time to first rescue analgesic (when VAS ≥4 cm or on demand), duration of postoperative analgesia, incidence of postoperative nausea-vomiting were also noted.Results:Pulse rate (95.9 ± 11.2 bpm vs. 102.9 ± 8.8 bpm, P = 0.001) systolic and diastolic BP were significantly higher in Group N. Median intraoperative fentanyl requirement was significantly higher in Group N (81 mcg vs. 114 mcg, P = 0.000). VAS scores on emergence at rest (median VAS 3 mm vs 27 mm), with activity (median 8 mm vs. 35 mm) were significantly lower in Group B. Median duration of analgesia was significantly higher in Group B (290 min vs. 16 min, P = 0.000). No complication or opioid related side effect attributed to TAP block were noted in any patient.Conclusion:Preincisional TAP block decreases intraoperative fentanyl requirements, prevents hemodynamic responses to surgical stimuli and provides effective postoperative analgesia.

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Section: Discussionsupporting

confidence: 91%

Analgesic efficacy of transversus abdominis plane block in providing effective perioperative analgesia in patients undergoing total abdominal hysterectomy: A randomized controlled trial

Bhattacharjee

Ray

Ghose

et al. 2014

J Anaesthesiol Clin Pharmacol

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“…The efficacy of TAP block for pain control after RT is controversial. The first report of using TAP block for RT by Mukhtar et al [13] showed decreased opioid requirements, pain scores, and nausea and vomiting in the postoperative period. However, a recent report by Freir et al [14] did not show any beneficial effect from using TAP block for pain relief in RT.…”

Section: Discussionmentioning

confidence: 99%

Continuous transversus abdominis plane block catheter analgesia for postoperative pain control in renal transplant

et al. 2014

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Purpose Continuous transversus abdominis plane (TAP) block using a catheter has proven its usefulness in reducing opioid requirements and pain scores after lower abdominal surgery. However, there are no reports of its successful use after renal transplant. We tested the hypothesis that continuous TAP block would retrospectively reduce opioid requirement, nausea score and hospital stay after renal transplant surgery. Methods In a retrospective study, we reviewed the data from 63 adult renal transplant recipients—31 with patient-controlled TAP analgesia with standing orders for intravenous as well as oral opioids as needed and 32 with intravenous patient-controlled analgesia. The TAP catheter was inserted preoperatively using an ultra-sound-guided technique. Infusion of ropivacaine 0.2 % at 8 ml basal, 12 ml bolus and a lockout interval of 60 min were maintained for 48 h postoperatively. The primary outcome was total morphine-equivalent dose during the 48-h postoperative period. Secondary outcomes were pain and nausea scores for the 48-h postoperative period. Results The mean 48-h postoperative morphine-equivalent doses [95 % confidence interval] for patient-controlled intravenous analgesia and TAP catheter were 197 [111, 349] and 50 [28, 90], respectively, which were significantly different (P = 0.002). The mean 48-h average verbal response pain scores were 2.94 [2.39, 3.50] and 2.49 [1.93, 3.06], respectively, which were not significantly different (P = 0.26). The mean nausea scores were 0.66 [0.46, 0.87] and 0.60 [0.40, 0.81], respectively, which were not significantly different (P = 0.69). There was no difference regarding hospital stay. Conclusion The use of continuous TAP analgesia for postoperative analgesia after renal transplant was effective in reducing the morphine-equivalent requirements.

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“…They have been described for kidney transplant recipients,2,3,5 liver transplant,17 and in control of immediate postoperative pain following pancreas transplant 18. To date, only one prospective study has described the use of TAP blocks in kidney donors 4.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The first three studies2–4 showed improved pain scores in patients receiving the TAP block, while Frier et al5 showed no benefit. Additionally, Mukhtar and Khattak showed a decrease in nausea in the TAP group 2. The aim of this prospective, randomized, double-blind, placebo-controlled study was to evaluate the efficacy of TAP blocks in providing analgesia for patients undergoing laparoscopic hand-assisted nephrectomy for either tumor resection or kidney donation.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-guided transversus abdominis plane blocks for patients undergoing laparoscopic hand-assisted nephrectomy: a randomized, placebo-controlled trial

Aniskevich¹,

Taner²,

Perry³

et al. 2014

LRA

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Postoperative pain is a common complaint following living kidney donation or tumor resection using the laparoscopic hand-assisted technique. To evaluate the potential analgesic benefit of transversus abdominis plane blocks, we conducted a randomized, double-blind, placebo-controlled study in 21 patients scheduled to undergo elective living-donor nephrectomy or single-sided nephrectomy for tumor. Patients were randomized to receive either 20 mL of 0.5% ropivacaine or 20 mL of 0.9% saline bilaterally to the transversus abdominis plane under ultrasound guidance. We found that transversus abdominis plane blocks reduced overall pain scores at 24 hours, with a trend toward decreased total morphine consumption. Nausea, vomiting, sedation, and time to discharge were not significantly different between the two study groups.

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Transversus abdominis plane block for renal transplant recipients

Cited by 48 publications

References 11 publications

Analgesic efficacy of transversus abdominis plane block in providing effective perioperative analgesia in patients undergoing total abdominal hysterectomy: A randomized controlled trial

Analgesic efficacy of transversus abdominis plane block in providing effective perioperative analgesia in patients undergoing total abdominal hysterectomy: A randomized controlled trial

Continuous transversus abdominis plane block catheter analgesia for postoperative pain control in renal transplant

Ultrasound-guided transversus abdominis plane blocks for patients undergoing laparoscopic hand-assisted nephrectomy: a randomized, placebo-controlled trial

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