A Case of Liver Trauma With a Blunt Regional Anesthesia Needle While Performing Transversus Abdominis Plane Block

Farooq, Muhammad; Carey, Michael

doi:10.1016/j.rapm.2007.11.009

Cited by 141 publications

(122 citation statements)

References 1 publication

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“…Only a few complications have been reported secondary to the TAP block: intrahepatic injection in a patient with hepatomegaly, 9 intraperitoneal TAP catheter misplacement without abdominal organ damage and an anaphylactic reaction after ropivacaine injection.…”

Section: Discussionmentioning

confidence: 99%

Transversus abdominis plane block after Caesarean section in an area with limited resources

Kahsay

Elsholz

Bahta

2017

Southern African Journal of Anaesthesia and Analgesia

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Background:The primary objective of this study was to assess whether transversus abdominis plane (TAP) block is effective as part of multimodal pain management following Caesarean section in an area with limited resources. The study also looked at the advantage of this block in reducing the consumption of morphine and diclofenac postoperatively. Methods: After approval by the institutional ethics committee and informed consent of participants, 108 ASA I and II patients for Caesarean section under spinal anaesthesia were randomly allocated to either the TAP block group or the control. The TAP block group received a landmark-orientated, bilateral TAP block in the triangle of Petit. Postoperative pain treatment followed the same protocol for both groups. Visual analogue scale (VAS) pain scores were measured at 2, 4, 6, 8, 12, 18 and 24 h postoperatively. At the same time, consumption of diclofenac and morphine was measured and compared. Results: No adverse effects of the TAP block were detected. VAS pain scores were significantly lower in the TAP block group at rest, deep breathing, intentional coughing, and mobilisation in all cases (p < 0. 05). Morphine and diclofenac consumption was significantly higher in the control group (p < 0. 001). Conclusion: TAP block reduced the VAS pain scores significantly both at rest and during stressors. As a result, morphine and diclofenac consumption was significantly reduced in the TAP block group. Therefore, it is feasible to implement TAP block as part of a multimodal analgesia regimen after Caesarean section in a tertiary health care centre in a developing nation.

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Section: Discussionmentioning

confidence: 99%

Transversus abdominis plane block after Caesarean section in an area with limited resources

Kahsay

Elsholz

Bahta

2017

Southern African Journal of Anaesthesia and Analgesia

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“…POP technique described by Rafi, is associated with difficulties like anatomic variation of triangle of petit, difficulty in palpation of triangle in obese patients and complications like colonic puncture, liver injury [5], nerve injury or unpredictable spread of local anesthetic [7].…”

Section: Discussionmentioning

confidence: 99%

Observational Study to Evaluate Transversus Abdominis Plane (TAP) Block in Abdominal Surgery by Total Requirement of Diclofenac as a Post Operative Analgesia drug

Patel¹,

Shah²,

Bhiwal³

2015

Int Jour of Biomed Res

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Background: Transversus Abdominis Plane Block (TAPB) is a regional anesthesia technique. It provides analgesia after lower abdominal surgery particularly where parietal wall pain forms major component of pain. It allows sensory blockade of lower abdominal wall skin and muscles via local anesthetic deposition between Transversus Abdominis muscle and internal oblique muscle. We evaluated efficacy of unilateral TAPB with bupivacaine for postoperative analgesia in hernia repair in a hospital based, double blind, and prospective, randomized controlled clinical trial. Method: 60 patients undergoing elective unilateral inguinal hernioplasty surgery were randomized to undergo TAPB with bupivacaine (n =30) in study group and without TAPB in control group (n=30). At end of surgery performed under spinal anesthesia unilateral TAPB on side of surgery was performed using 20 ml of 0.25 % bupivacaine in study group. Each patient was assessed postoperatively by a blinded investigator in postanesthesia care unit at 30 min., 2, 4, 6, 12, 18, 24 hours. The time required for first dose of rescue analgesia, vas score, total consumption of diclofenac was assessed in each group and comparison were performed by student ttest. Result: Mean duration of analgesia was 669.66 minutes with SD of +346 in study group and 220.33 minutes with SD of +139.24 in control group which was found to be statistically significant. VAS score was significantly higher in control group as compared to the study group at all the time. Total dose of diclofenac consumption in study group was 95±33.73mg and in control group it was 202.5±44.69mg, which showed that diclofenac consumption was significantly decreased in study group. Conclusion: TAPB with 0.25% bupivacaine provided potent and longer duration of analgesia, with very less requirement of diclofenac when used in patients of inguinal hernioplasty. There were no complications attributable to TAPB or drugs under study.

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“…An additional advantage of the US-guided technique is that it may decrease complication rates, such as hepatic injuries, previously described with the blind technique. 5 Prolonged TAP blocks using indwelling catheters and continuous local anesthetic infusions have been described in a few cases, i.e., for postoperative pain management in renal transplant recipients, abdominal midline surgical incisions, and inguinal hernia repairs, with promising results. 2,6,7 The TAP block is an interfascial block, and the target nerves cannot be visualized under US.…”

Section: Discussionmentioning

confidence: 99%

Continuous lumbar transversus abdominis plane block may spread to supraumbilical dermatomes

Forero

Neira

Heikkila

et al. 2011

Can J Anesth/J Can Anesth

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Purpose The transversus abdominis plane block is an interfascial block intended to target nerves supplying the abdominal wall. It has been shown to reduce pain and postoperative opioids in abdominal surgeries. We present the case of a high-risk patient in whom bilateral continuous lumbar transversus abdominis plane blocks provided effective postoperative analgesia following infraumbilical midline laparotomy. Clinical features A 59-yr-old woman with coronary artery disease, severe peripheral vascular disease, and mild to moderate obstructive sleep apnea underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection via an infraumbilical midline laparotomy. Bilateral ultrasound-guided lumbar transversus abdominis plane blocks with catheters were sited intraoperatively. Using only a continuous local anesthetic infusion in the postoperative period, the patient required no systemic opioids or acetaminophen for 81 hr. A sensory block level of T6-L1, higher than that reported following a single-shot technique, remained for 24 hr following infusion discontinuation and finally normalized after 33 hr.

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A Case of Liver Trauma With a Blunt Regional Anesthesia Needle While Performing Transversus Abdominis Plane Block

Cited by 141 publications

References 1 publication

Transversus abdominis plane block after Caesarean section in an area with limited resources

Transversus abdominis plane block after Caesarean section in an area with limited resources

Observational Study to Evaluate Transversus Abdominis Plane (TAP) Block in Abdominal Surgery by Total Requirement of Diclofenac as a Post Operative Analgesia drug

Continuous lumbar transversus abdominis plane block may spread to supraumbilical dermatomes

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