Transversus abdominis plane block: The new horizon for postoperative analgesia following abdominal surgery

Mishra, Manjaree; Mishra, Shashi Kant

doi:10.1016/j.egja.2015.12.003

Cited by 17 publications

(17 citation statements)

References 37 publications

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“…The studies have shown that TAP block provides significant analgesic effect, especially below T 10 up to L1 level; hence, it is perfectly suited for use after lower abdominal and gynecological surgeries [9] . Although most of the available studies on TAP block have used Local Anesthetic (LA) agent, few studies have reported that the adjuvant medications were added to LA to prolong the effect of TAP block.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Guided Transversus Abdominis Plane Block Using Dexmedetomidine and Bupivacaine in Children Undergoing Laparoscopic Orcheopexy: Randomized Controlled Trial

Herdan¹,

Aborima

2019

The Medical Journal of Cairo University

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Background: To assess the onset time, duration and postoperative analgesic efficacy of ultrasound guided TAP block in children with undescended testis who underwent laparoscopic orcheopexy. Aim of Study: The addition of dexmedetomidine to bupivacaine in TAP block achieves better local anesthesia quality and provides better pain control postoperatively without any major side-effects. Patients and Methods: A prospective randomized controlled double blind study using a computer generated randomization was conducted in Assiut University between March 2016 and September 2017. Results: Regarding SpO 2 and HR of the studied groups at different times; it was noticed that there was no statistically significant differences between the two groups (p>0.05). Regarding end tidal CO 2 measurements, there was a statistically significant difference (p<0.05) after induction, at 10 minutes and at 70 minutes. There was statistically significant difference (p<0.001) after 30-60 minutes and from 80 minutes up to end of surgery with higher mean values at Group A. There was no statistically significant difference at others times. For mean arterial blood pressure recordings, there was statistically significant difference (p>0.001) from time before induction up to after 40 minutes, 80 minutes and at end. There was no statistically significance difference (p>0.05) at time 50-70 minutes, 90 minutes and before extubation. Regarding post-operative pain scores, in Cry, Facial and Torso there was no statistically significant difference at 4 hours, but there was statistically significant difference (p<0.001) at 8 and 12 hours. As regarding child verbal, touch and legs there was a statistically significant difference (p<0.05) at 4, 8 and 12 hours. Regarding frequency of post-operative analgesic request, there was a statistically significant difference between Groups A and B (p<0.05) with (85.0%) request analgesia in Group A vs. (60.0%) in Group B. Egarding the time of the first analgesic request, there was statistically significant difference between Group A and Group B (p<0.001) with higher mean values in Group B than Group A.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Guided Transversus Abdominis Plane Block Using Dexmedetomidine and Bupivacaine in Children Undergoing Laparoscopic Orcheopexy: Randomized Controlled Trial

Herdan¹,

Aborima

2019

The Medical Journal of Cairo University

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“…It has got potential to substitute the use of intravenous opioid analgesics and hence to avoid its complications. It has been proved to cater significant analgesic effect especially below T10 up to L1 level [55][56][57][58][59].…”

Section: Transversus Abdominis Plane Block (Tap Block)mentioning

confidence: 99%

“…The patient is positioned supine in both techniques [60]. There are two common techniques for TAP block [57][58][59][60][61]: (1) The blind TAP: the point of entry for the blind TAP is the lumber triangle of Petit. The needle is inserted cephalad to the iliac crest and advanced until two distinct "pops" are felt as the needle transverses the external oblique and internal oblique muscles.…”

Section: Transversus Abdominis Plane Block (Tap Block)mentioning

confidence: 99%

Pain Management in Plastic Surgery

Aribawa¹,

Wiryana²,

Senapathi³

et al. 2019

Anesthesia Topics for Plastic and Reconstructive Surgery

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Most patients who undergo cosmetic surgery do not report pain during the immediate postoperative period. However, most patients who underwent liposuction combined with or without other plastic surgical procedure suffer pain after surgery. There are three main techniques in acute pain management postoperatively which are systemic analgesia, regional analgesia, and local/topical analgesia, and these are the extent of trauma during the procedure, surgeon's skill, prior disease, location and type of incision, and psychological and cultural factors. Treatment for each type of plastic surgery and the resulting pain require techniques that can be used as single method or combined with each other to relieve postoperative pain after plastic surgery. Nausea, vomiting, constipation, somnolence, etc., are well-known adverse effects of opioids. Although these effects may seem minor, they can lead to significant complications following some type of plastic surgeries, for example, face-lift hematoma following nausea and vomiting, pulmonary complications from respiratory depression, and even thromboembolic phenomena from bed rest following prolonged opioid use. Multimodal pain management has been documented to increase patient satisfaction and reduce both opioid use and the incidence of PONV. Combination of pain management in plastic surgery included patient-controlled analgesia intravenous (PCA-IV), patient-controlled epidural analgesia (PCEA), patientcontrolled regional analgesia (PCRA), field block (TAP block), continuous wound infusion system using pain pump and tumescent analgesia with local anesthetics.

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“…TAP block is capable of giving good analgesic effect in the region between T10 and L1 following a single posterior infiltration (in midaxillary line) and to achieve higher block up to T6, it needs to be augmented with an anterior subcostal infiltration. 8 Various studies have been conducted for the postoperative analgesia in abdominal surgeries by comparing the TAP block with placebo or local wound infiltration. In this study, we compared postoperative analgesia in two groups by giving TAP block using ropivacaine and ropivacaine-dexmedetomidine (RD) combination.…”

mentioning

confidence: 99%

Comparative study of ropivacaine versus dexmedetomidine-ropivacaine combination in transversus abdominis plane block for postoperative pain control in plastic surgery patients undergoing abdominoplasty

Jan¹,

Ahmad²,

Rashid³

2019

Int Surg J

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Background: Requirement of postoperative analgesic medication is decreased by the use of regional nerve blocks. Transversus abdominis plane (TAP) block is an effective way to provide postoperative analgesia in abdominal surgeries. TAP block using ropivacaine alone has not been consistently proven to be effective in alleviating pain after abdominal surgeries. The objective of the study was to compare the combination of dexmedetomidine and ropivacaine to ropivacaine alone in TAP block for abdominoplasty patients. Time to onset of post-operative pain and time interval for need of rescue analgesia were compared.Methods: Sixty ASA (American Society of Anesthesiology) grade I or II patients undergoing abdominoplasty were allocated to two groups with thirty patients in each group. In this randomized, controlled, double-blinded study, the test group received TAP block using 20 ml (100 mgs) 0.5 percent of ropivacaine mixed with 50 µg of dexmedetomidine while as Control group received TAP block with 20 ml (100 mgs) of 0.5 percent of ropivacaine alone. Patient demographics, time to initial reporting of post-operative pain, time to need of first rescue analgesia, quality of pain block and side effects were recorded.Results: Time to initial onset of pain and time to need of first rescue analgesia were significantly longer in the test group than control group. The two groups were similar in demographics and quality of pain block, with no significant difference in side effects.Conclusions: Addition of dexmedetomidine to ropivacaine for TAP block in abdominoplasty patients prolong the time to initial onset of pain and time to need for first rescue analgesia.

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Transversus abdominis plane block: The new horizon for postoperative analgesia following abdominal surgery

Cited by 17 publications

References 37 publications

Ultrasound Guided Transversus Abdominis Plane Block Using Dexmedetomidine and Bupivacaine in Children Undergoing Laparoscopic Orcheopexy: Randomized Controlled Trial

Ultrasound Guided Transversus Abdominis Plane Block Using Dexmedetomidine and Bupivacaine in Children Undergoing Laparoscopic Orcheopexy: Randomized Controlled Trial

Pain Management in Plastic Surgery

Comparative study of ropivacaine versus dexmedetomidine-ropivacaine combination in transversus abdominis plane block for postoperative pain control in plastic surgery patients undergoing abdominoplasty

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