Ultrasound-guided transversus abdominis plane block for lower abdominal surgeries: bupivacaine alone or combined with fentanyl or epinephrine

Metwally, Ahmed A.; Abo-El-Enin, Khalid M; Allah, Sabry I Abd; Soliman, N.; Abo-Omar, Walid A

doi:10.4103/1110-2098.215478

Cited by 4 publications

(2 citation statements)

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“…Our findings were like that of G. Neeraj et al, 4 Neerja Bharti et Though the Visual analogue scale (VAS) score, which is a subjective tool, was used for post-operative pain measurement, post-operative hemodynamic variability to pain remains an objective tool to confirm the severity of pain. 18 Tachycardia, increased blood pressure and tachypnoea indicate the experience of pain if no other pathology or cause is present. A decrease in respiratory rate may also indicate respiratory depression followed by tramadol injection, as a side effect.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of ultrasound-guided TAP block for postoperative pain relief in abdominal surgeries: A prospective, randomized controlled trial

Sanghavi,

Shelgaonkar

2023

IJCA

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: Transversus abdominis plane (TAP) block has emerged as a safe, reliable, and efficient technique to provide post-operative analgesia for a range of abdominal procedures and has been shown to minimize the usage of opioids in the perioperative period. This paper compares the overall efficacy and safety of TAP block for postoperative analgesia in abdominal surgeries, by two techniques (blind v/s USG). Eighty patients, ASA grade I-II, 18-60 years age group, posted for abdominal surgery like appendicectomy, appendicular perforation, umbilical, paraumbilical, incisional and ventral hernia repair, hysterectomy and exploratory laparotomy under GA. They were divided into two groups to undergo blind or USG-guided TAP block. At the end of the procedure, before the reversal, both groups received a TAP block with Inj. Bupivacaine 0.25% 20cc on each side in supine position. Patients were followed up for 24 hours, and pain scores were measured using a visual analogue scale. Inj. Diclofenac was given as rescue analgesic and Inj. Tramadol was used for breakthrough pain. Total analgesic requirement for 24 hours and complications if any, were noted.: VAS score was found to be significantly lower in USG- guided group at various time intervals till 12 hours (2.05 ± 0.75 vs 2.98 ± 1.03) in the USG-guided group as compared to the blind group (p<0.05). Time to first rescue analgesic was significantly prolonged in USG- the guided group being 19.68 ± 4.90 hours than the blind technique of 13.48 ± 6.86 hours (p <0.001). The number of rescue analgesics required in the USG-guided group was significantly lower than the blind technique (p<0.05).: USG-guided group had significantly less pain scores postoperatively and a reduced number of analgesic requirements. This resulted in fewer opioid-mediated side effects. TAP block can serve as a part of multimodal analgesia with enhanced recovery after abdominal surgery. The USG-guided approach helped in achieving near perfect block which is evident by pain scores and reduced analgesics required.

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Section: Discussionmentioning

confidence: 99%

Efficacy of ultrasound-guided TAP block for postoperative pain relief in abdominal surgeries: A prospective, randomized controlled trial

Sanghavi,

Shelgaonkar

2023

IJCA

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“…Complications of transversus abdominis include bowel hematoma, transient palsy of the femoral nerve, perforation of the peritoneum, perforation of the diaphragm, vascular injury, local anaesthetic toxicity and liver lacerations [8]. With the ultrasound-guided approach, the aforementioned TAP block concerns could be lessened since it enables real-time viewing of the needle tip and pertinent anatomical structures, increasing the margin of safety [9].…”

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confidence: 99%

Comparison of Dexamethasone Versus Methylprednisolone With Bupivacaine in Transversus Abdominis Plane Block for Attenuation of Chronic Postoperative Abdominal Pain

Modak,

Paul,

Chakole

et al. 2023

Cureus

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BackgroundOpioids, which have well-known adverse effects such as drowsiness paralytic ileus and respiratory depression, were mostly utilised to treat postoperative pain in the past. The increased incidence of side effects has led to a rise in interest in pain management techniques that spare opioids. Persistent abdominal pain following surgery has a major detrimental effect on patients' quality of life. While epidural analgesia is widely regarded as the gold standard to combat the pain that is present post abdominal surgeries, it is not devoid of drawbacks. The transversus abdominis plane (TAP) block has developed as a potentially effective treatment for severe abdominal pain. The TAP block acts on the neuro-fascial plane between the internal oblique and transversus abdominis muscles, which is innervated by spinal nerves from T6 to L1. Studies reveal that the addition of corticosteroids to bupivacaine in TAP blocks provides pain relief and improves the quality of life of the patient.

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Comparative study of dexmedetomidine versus fentanyl as adjuvants to bupivacaine in ultrasound-guided transversus abdominis plane block in patients undergoing radical cystectomy: a prospective randomised study

et al. 2022

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Background Transversus abdominis plane (TAP) block is beneficial for pain management after conducting abdominal surgery. Objective To compare the outcomes of dexmedetomidine and fentanyl, as adjuvants to bupivacaine, for ultrasound-guided TAP block analgesia among patients undergoing radical cystectomy for postoperative pain management. Methods This prospective, randomised, comparative study included a total of 60 patients, who underwent radical cystectomy. Participants were randomly divided into three categories with 20 subjects each; group B had patients who received a single shot US-guided TAP block on each side with 20 ml of 0.25% bupivacaine + 2 ml normal saline; group BF had patients who received a single shot US-guided TAP block on each side with 20 ml of 0.25% bupivacaine + 1 µg/kg fentanyl dissolved in 2 ml normal saline and group BD had patients who received a single shot US-guided TAP block on each side with 20 ml of 0.25% bupivacaine + 1 µg/kg dexmedetomidine dissolved in 2 ml normal saline.The researchers recorded the time taken for first rescue analgesia, total analgesic dose in the first 24 h after surgery, patient satisfaction, sedation score, and postoperative complications. Results The time taken for first rescue analgesia was significantly lengthier in group (BD) (8.90 ± 2.47) than (BF) (6.50 ± 1.43) and (B) (4.40 ± 1.05) groups. The total nalbuphine consumption, during the first 24 h, was significantly lower in (BD) (0.15 ± 0.00) group compared to (BF) (0.20 ± 0.07) and (B) (0.24 ± 0.08) groups. Conclusion In comparison with fentanyl, as an adjuvant to bupivacaine, dexmedetomidine was found to be associated with prolonged postoperative analgesia, less postoperative pain scores and low opioid consumption. Trial registration This study was registered at Clinical Trials.gov on 23 March 2020 (registration number: NCT04318158).

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Ultrasound-guided transversus abdominis plane block for lower abdominal surgeries: bupivacaine alone or combined with fentanyl or epinephrine

Cited by 4 publications

References 1 publication

Efficacy of ultrasound-guided TAP block for postoperative pain relief in abdominal surgeries: A prospective, randomized controlled trial

Efficacy of ultrasound-guided TAP block for postoperative pain relief in abdominal surgeries: A prospective, randomized controlled trial

Comparison of Dexamethasone Versus Methylprednisolone With Bupivacaine in Transversus Abdominis Plane Block for Attenuation of Chronic Postoperative Abdominal Pain

Comparative study of dexmedetomidine versus fentanyl as adjuvants to bupivacaine in ultrasound-guided transversus abdominis plane block in patients undergoing radical cystectomy: a prospective randomised study

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