Transversus Abdominis Plane Block to Ameliorate Postoperative Pain Outcomes After Laparoscopic Surgery

Abstract

TAP block is an effective strategy to improve early and late pain at rest and to reduce opioid consumption after laparoscopic surgical procedures. In contrast, the TAP block was not superior compared with control to reduce early and late pain during movement. Preoperative administration of a TAP block seems to result in greater effects on postoperative pain outcomes. We also detected a local anesthetic dose response on late pain and postoperative opioid consumption.

Comparison of analgesic efficacy of oblique subcostal and lateral transversus abdominis plane block after laparoscopic cholecystectomy

“…TAP blocks have been reported to reduce postoperative VAS, morphine consumption, and systemic analgesic requirements, and to reduce opioid-related side effects after abdominal surgeries, including laparoscopic surgery, as compared with placebo blocks [2,[14][15][16][17][18]. Previous reports have shown TAP blocks provide significant pain relief from within 2 hours of laparoscopic surgery, but not at 24 hours postoperatively [15,18].…”

Transversus Abdominis Plane Block to Alleviate Postoperative Pain in Children: A Meta-Analysis of Randomized Controlled Trials

“…Some researchers have suggested that minimizing the dose of opioid analgesics could reduce the side effects (30). The previous meta-analyses in adult have demonstrated the significant reduction of opioid usage in regional anesthesia treated adults group while comparing with placebo treated group, and the side effect of opioids such as nausea, sedation, and pruritus were reduced due to the lower opioid consumption (14,31,32). Thus, for children, we speculated that the treatment of TAP block may reduce the occurrence of side effect related with opioid analgesics through the decrease of opioid usage.…”

“…Meanwhile, we did not observe the significant difference in the time of first opioid analgesic requirement between TAP block and control group. As the first time of opioid usage are usually at the early stage after surgery (14,21,22,25), we speculated that TAP block cannot fully alleviate the early postoperative pain. However, as the time passed, the analgesia effect of TAP block gradually played a role on the postoperative pain management.…”

“…Thus, the preoperative administration of the TAP block seemed optimal to manage postoperative pain and reduce the opioid consumption. The early meta-analysis also preferred the preoperative administration of TAP block to the postoperative administration of the block on the management of early pain at rest and reduction of postoperative opioid consumption (14). Besides, as the opioid analgesics were usually applied according to the subjective pain measurement strategies, it was possible that the anxiety sensitivity, catastrophizing and parental responses may contribute to higher estimations of the children's pain intensity and stronger solicitousness of opioid analgesic, which created greater number of children needed postoperative opioid analgesia rescue than actual (33,34).…”

“…TAP block has been reported by Rafi at first time as early as 2001 (12), and in 2007 ultrasound was reported to use as guidance during the TAP block (13). A group of reviews and meta-analyses have investigated the analgesic effects of TAP block in various adult surgeries, such as laparoscopic surgery (14), hysterectomy (15) and caesarean delivery (16). However, there are few reviews on the analgesic outcomes for postoperative pain in children, and it remains to determine whether TAP block can improve the postoperative pain management in children.…”