A Simple Modification to the Transversus Abdominis Plane Block Provides Safe and Effective Analgesia in TRAM/DIEP Flap Patients

West, Chris; Milner, Chris S.

doi:10.1097/prs.0b013e3181e3b531

Cited by 12 publications

(7 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, preliminary cadaveric studies suggest that, for the lateral approach, a minimal volume of 15 ml is required 46 and, for the subcostal approach, a multiple-injection technique (along the costal margin) provides more extensive coverage than its single injection counterpart. 47 In 2010, West et al 48 and Araco et al 49 described for the first time the intraoperative performance of transversus abdominis plane blocks by surgeons. Since these initial…”

Section: Optimal Technique For Transversus Abdominis Plane Blocksmentioning

confidence: 99%

“…In fact, the number of permutations of transversus abdominis plane blocks is much greater with surgical than with (anesthesiologist-driven) percutaneous methods. For instance, like anesthesiologists, surgeons can target all three (subcostal, lateral, and posterior) transversus abdominis plane compartments 48,50 in the setting of open (laparotomy) 48 or laparoscopic 51 incisions. However, they can also perform transversus abdominis plane blocks by going through the abdominal wall 48,50,51 or through the peritoneum.…”

Section: Transversus Abdominis Plane Blockmentioning

confidence: 99%

See 1 more Smart Citation

Transversus Abdominis Plane Block

et al. 2019

View full text Add to dashboard Cite

In this narrative review article, the authors discuss the anatomy, nomenclature, history, approaches (posterior vs. lateral vs. subcostal), techniques, pharmacology, indications, and complications of transversus abdominis plane blocks, as well as possible alternative truncal blocks. Despite the scarcity of evidence and contradictory findings, certain clinical suggestions can nonetheless be made. Overall transversus abdominis plane blocks appear most beneficial in the setting of open appendectomy (posterior or lateral approach). Lateral transversus abdominis plane blocks are not suggested for laparoscopic hysterectomy, laparoscopic appendectomy, or open prostatectomy. However, transversus abdominis plane blocks could serve as an analgesic option for Cesarean delivery (posterior or lateral approach) and open colorectal section (subcostal or lateral approach) if there exist contraindications to intrathecal morphine and thoracic epidural analgesia, respectively. Future investigation is required to compare posterior and subcostal transversus abdominis plane blocks in clinical settings. Furthermore, posterior transversus abdominis plane blocks should be investigated for surgical interventions in which their lateral counterparts have proven not to be beneficial (e.g., laparoscopic hysterectomy/appendectomy, open prostatectomy). More importantly, because posterior transversus abdominis plane blocks can purportedly provide sympathetic blockade and visceral analgesia, they should be compared with thoracic epidural analgesia for open colorectal surgery. Finally, transversus abdominis plane blocks should be compared with newer truncal blocks (e.g., erector spinae plane and quadratus lumborum blocks) with well-designed and adequately powered trials.

show abstract

Section: Optimal Technique For Transversus Abdominis Plane Blocksmentioning

confidence: 99%

Section: Transversus Abdominis Plane Blockmentioning

confidence: 99%

Transversus Abdominis Plane Block

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Young et al [7] reported two cases of liver injury in hepatomegaly patients after lateral approach of TAP block.Araco et al [15, 1230 16]in 2010 described an open TAP block technique administered by the surgeon himself during abdominoplasty. West and Milner [17] also reported in a letter to the editor that a surgeon-performed TAP block was beneficial after deep inferior epigastric artery perforator flap and transverse rectus abdominis myocutaneous flap procedures.…”

Section: Discussion:-mentioning

confidence: 99%

Early Recovery Following Ultrasound-Guided Transversus Abdominis Plane Block (Tap) in Abdominal Contouring Surgeries

Alotaibi¹,

Hamza²,

Rabah³

et al. 2020

IJAR

View full text Add to dashboard Cite

Background:The transversus abdominis plane (TAP) block is a well-known regional nerve block that is used for the pain control after various inguinal andabdominal surgeries. The most effective and well known method of administering the TAP block is under ultrasound guidance.Till now only few studies have evaluated analgesic efficacy of TAP block in Abdominoplastysurgical procedure, in which post-operative pain is a major concern for both surgeon as well for the patient. Objectives:We conducted retrospective cohort study to assess efficacy of ultrasound-guided bilateral TAP block, in controlling post-operative pain in abdominoplasty patients. Methods:Sixty Patients who had undergone Lipoabdominoplasty procedurewere studied retrospectively. The patients who had received TAP block were assigned as groups A and those patients who had not received any TAP block were assigned as group B, with thirty Patients in each group.The patients in two groups were compared for their demographic characteristics, pain intensity on mobilization, time to first rescue analgesic dose (visual analog scale (VAS) score ≥ 5 or on demand), opioid consumptionand incidence of nausea-vomitingepisodes during first post-operative 24 hours. Results:The patients in two groups were similar in demographic characteristics. Patients in group A (TAP block group) had required significantly smaller mean dose of postoperative opioids (Group A: 5mg Group B: 75 mg P = <0.000) and hadsignificantly longer mean time of first request for analgesic medication (Group A: 8 hours 11 minutes Group B: 1 hours 20 minutes P = <0.000).Median VAS score on mobilization was significantly lower in Group A(group A: 1 Group B: 5).Only Three patients in group A as compared to 18 patients in group B had experienced nausea and vomiting in post-operative period. Conclusions:The ultrasound guided TAP block provide more effective analgesia after Lipoabdominoplasty, which allows more comfortable early post-operative mobilization, decreases opioid requirement as well as opioid related side-effects, Therefore ultrasound guided TAP block should be considered in most of lipoabdominoplasty patients for better patient experience and outcome.

show abstract

“…The decade following the inception of TAP blockade has seen a growing body of evidence appraise its efficacy in a large range of patients and procedures, its methods of action and variants of technique. Fourteen clinical studies have assessed its analgesic effect in major abdominal surgery, 22 39 and open prostatectomy. 40 Three RCTs in obstetric and gynaecological surgery found no benefit with TAP block.…”

Section: Addition Of Transversus Abdominis Plane Block To Patient Conmentioning

confidence: 99%

Addition of transversus abdominis plane block to patient controlled analgesia for laparoscopic high anterior resection improves analgesia, reduces opioid requirement and expedites recovery of bowel function

Ris

Findlay

Hompes

et al. 2014

annals

View full text Add to dashboard Cite

INTRODUCTION Opioid sparing in postoperative pain management appears key in colorectal enhanced recovery. Transversus abdominis plane (TAP) blocks offer such an effect. This study aimed to quantify this effect on pain, opioid use and recovery of bowel function after laparoscopic high anterior resection. METHODS This was a retrospective analysis of prospective data on 68 patients. Patients received an epidural (n=24), intravenous morphine patient controlled analgesia (PCA, n=22) or TAP blocks plus PCA (n=22) determined by anaesthetist preference. Outcome measures were numerical pain scores (0-3), cumulative intravenous morphine dose and time to recovery of bowel function (passage of flatus or stool). RESULTS There were no differences in patient characteristics, complications or extraction site. The TAP block group had lower pain scores (0.7 vs 1.36, p<0.001) and morphine requirements (8mg vs 15mg, p=0.01) than the group receiving PCA alone at 12 hours and 24 hours. Earlier passage of flatus (2.0 vs 2.7 vs 3.4 days, p=0.002), stool (3.1 vs 4.1 vs 5.5 days, p=0.04) and earlier discharge (4 vs 5 vs 6 days, p=0.02) were also seen. CONCLUSIONS Use of TAP blocks was found to reduce pain and morphine use compared with PCA, expedite recovery of bowel function compared with PCA and epidural, and expedite hospital discharge compared with epidural.

show abstract

A Simple Modification to the Transversus Abdominis Plane Block Provides Safe and Effective Analgesia in TRAM/DIEP Flap Patients

Cited by 12 publications

References 3 publications

Transversus Abdominis Plane Block

Transversus Abdominis Plane Block

Early Recovery Following Ultrasound-Guided Transversus Abdominis Plane Block (Tap) in Abdominal Contouring Surgeries

Addition of transversus abdominis plane block to patient controlled analgesia for laparoscopic high anterior resection improves analgesia, reduces opioid requirement and expedites recovery of bowel function

Contact Info

Product

Resources

About