Analgesic efficacy of laparoscopic-guided transverse abdominis plane block using liposomal bupivacaine in bariatric surgery

Bhakta, Avinash; Glotzer, Owen; Ata, Ashar; Tafen, Marcel; Stain, Steven C.; Singh, Priyanka

doi:10.1016/j.amjsurg.2017.09.006

Cited by 29 publications

(18 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study failed to demonstrate the TAP block’s ability to significantly relieve postoperative pain in our patients, but we believe that there are modifications that can be made to our TAP blocks which may yield better analgesic effects. Since we did find the TAP block to be effective in the period immediately following surgery, perhaps using a longer acting analgesic agent such as liposomal bupivacaine may provide more effective pain relief as recent studies have demonstrated that this formulation can provide longer pain control compared to traditional bupivacaine [ 13 ]. Employing a continuous TAP block through a catheter may also extend the duration of the block as some studies suggest this is a superior technique to a single shot block [ 14 - 15 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Transversus Abdominis Plane Block for Abdominal Hysterectomy Post-operative Analgesia

Dai

Zhang

Huang

2018

Cureus

View full text Add to dashboard Cite

Introduction/backgroundAbdominal hysterectomy is an open surgical procedure associated with considerable post-operative pain. Narcotics are often required during patient recovery but can result in adverse side effects. Transversus abdominis plane block (TAP block) is a regional anesthetic technique that is found to be an effective post-operative analgesia for many types of abdominal surgeries, including abdominal hysterectomies. However recent literature shows contradicting results regarding TAP block’s analgesic effect on recovery from abdominal hysterectomies. This study investigated the efficacy of TAP block to reduce narcotic consumption and improve pain scores in abdominal hysterectomy patients.MethodsA single-center retrospective cohort study was performed. The inclusion criteria was patients who underwent abdominal hysterectomy at Winnie Palmer Hospital for Women & Babies (WPH) between January 12, 2015 and December 31, 2015. Exclusion criteria were patients who received a second surgery within the same hospitalization, experienced an in-hospital mortality event, received hysterectomy for known malignancy, stayed in the hospital less than 24 hours, and whose charts contained missing data points.Data collected were: age, weight, height, body mass index (BMI), length of hospital stay, total narcotic consumption (intra-operation, in the post-anesthesia care unit (PACU), first 24 hours after admittance, during entire hospital stay, total patient-controlled analgesia (PCA) quantity, and total oral narcotics quantity. All narcotics were converted into parental morphine units for analysis. Numeric pain rating scale (NPRS) scores at two, four, eight, 12, 16, 20, and 24 hours after leaving the PACU were collected. Two-tailed paired T-test was performed to compare the narcotic consumption and pain scores between the TAP block group and the non-TAP block group.ResultsWPH used ultrasound-guided bilateral TAP block for patients undergoing abdominal hysterectomies. 63 patient charts were evaluated with 32 in the TAP block group and 31 in the non-TAP block group. Narcotic consumption was significantly different in the PACU with TAP block group consuming less narcotics than non-TAP block group (5.05 vs 8.65 IV morphine equivalents, p=0.012). TAP block group’s mean narcotic consumption was not significantly lower than Non-TAP block group’s mean consumption during intra-operation, first 24 hours after admittance, and total hospital stay (p=0.419, p=0.533, p=0.754 respectively). Mean NPRS scores at all hours (2, 4, 8, 12, 16, 20, and 24) displayed no statistical difference between the two groups. Total patient-controlled analgesia (PCA) and total overall oral narcotic usage showed no statistically significant differences between TAP block group and Non-TAP block group (p=0.252, 0.669 respectively).ConclusionThe results of this study demonstrated that TAP block did reduce narcotic requirement in the PACU but did not exhibit superior analgesic efficacy after discharge from the PACU, nor reduce the total length of hospital stay.

show abstract

Section: Discussionmentioning

confidence: 99%

The Efficacy of Transversus Abdominis Plane Block for Abdominal Hysterectomy Post-operative Analgesia

Dai

Zhang

Huang

2018

Cureus

View full text Add to dashboard Cite

show abstract

“…In a retrospective study of patients undergoing laparoscopic sleeve gastrectomy and laparoscopic gastric bypass, there was a significant reduction in opioid use by 36 MME and 44 MME, respectively, by using TAP block [9]. In another retrospective review of patients for bariatric surgery, there was a reduction by 44 MME when TAP block was used [17]. Hutchins, et al assessed this treatment option on living donor nephrectomies and found a significant decrease by 23 MME at 48-72 h with no difference at 0-24 h or 24-48 h [18].…”

Section: Discussionmentioning

confidence: 99%

Reducing Opioid Dependence and Improving Patient Experience for Living Kidney Donors with Transversus Abdominis Plane Block

Cohen

Haakinson

et al. 2021

Transplantology

View full text Add to dashboard Cite

Rapid recovery after laparoscopic living donor nephrectomy (LLDN) for kidney donation is highly desirable for living kidney donors. To uphold rapid recovery, good analgesia with minimal adverse effects, including those related to opioid dependence, is essential. A pre-operative transversus abdominis plane (TAP) block with liposomal bupivacaine can effectively aid in perioperative pain management, while reducing opioid requirements. We conducted a single-center retrospective study involving patients 18 years and older who underwent LLDN to determine whether a TAP block with liposomal bupivacaine is efficacious in pain management after LLDN, while reducing opioid use. The study group comprised of patients who received a preoperative TAP block with liposomal bupivacaine in place of hydromorphone patient-controlled analgesia (PCA) and the control group included patients who received hydromorphone PCA post-operatively. Both groups were supplemented with oral and intravenous analgesics for breakthrough pain, as needed. The primary endpoint was reduction in post-operative opioid use in morphine milligram equivalents (MME). Secondary endpoints included: post-operative pain scores, postoperative length of stay, and re-hospitalizations within 7 days of discharge. Sixty-six patients were included in our study, with 33 in each group. Patients in both groups were well matched demographically. The study group who received TAP block demonstrated a significant reduction in post-operative opioid use (92.05 MME vs. 53.98 MME, p < 0.05) when compared to the control group who received hydromorphone PCA. Both groups achieved similar analgesia with comparable pain scores. There was no difference between postoperative hospital lengths of stay for both groups. Two patients in the control group were re-admitted due to small bowel obstruction within seven days of discharge. In conclusion, TAP block with liposomal bupivacaine significantly reduced postoperative opioid use, while also proving to be safe, efficacious and feasible in patients undergoing LLDN.

show abstract

“…This significant post-operative pain relief which can be achieved by TAP block was confirmed by Chang et al in 2018 26 and Chistian et al in 2018 27 . Also Bhaleta et al in 2018 had demonstrated that this TAP block can be used for laparoscopic gynecological surgeries as well 28 .…”

Section: Discussionmentioning

confidence: 99%

Determine the effectiveness of post-operative pain management of ultrasound guided transversus abdominis plane block vs open internal transversus abdominis plane block following abdominal hysterectomy a randomized controlled study

Randombagea

Hemapriya

Gnanarathna

2020

Sri Lanka J Obstet & Gynae

View full text Add to dashboard Cite

Introduction: Abdominal hysterectomy is a common surgical procedure associated with considerable post-operative pain. The surgical outcomes are generally improved when pain control is optimized in the postoperative period. The transversus abdominis plane (TAP) block is an evolving regional anesthetic technique which provides analgesia to the skin, muscle and parietal peritoneal layers of anterior abdominal wall leading to reduction of post-operative pain. Objectives: To compare the effectiveness in reducing postoperative pain between ultrasound guided TAP block, open internal TAP block and without TAP block in patients undergoing abdominal hysterectomy under general anaethesia. Methods: Three-armed randomized case control prospective study conducted in Teaching Hospital Kandy from August 2016 to May 2017. Sixty six (66) patients scheduled and admitted for abdominal hysterectomy via supra-pubic transverse incision under general anaesthesia, aged between 40-60 years were included. Block randomization technique was applied to achieve the allocation concealment. There were 22 participants in each group of each arm. The Group 1 received USS guided TAP block, Group 2 open TAP block and Group 3 neither TAP block administered. The key data collected by a blinded observer at 12, 24 and 48 post-operative points were analgesic requirements and the analogue pain scale measurements of post-operative pain. These were compared in three groups. 95% confidence interval and 0.05 probability cut off were used to determine statistical significance. Results: The Mean age of the all participants was 51.98 years (SD=8.36) and length of the surgical incision ranged from 10cm to 13cm. Mean weight of participants was 60.69kg (SD-7.0kg). Majority of the surgeries were completed in less than 45 minutes (n=42:63.6%). There was no significant difference in above three measurements in the three groups. The difference in mean pain score in all 3 study groups were statistically significant at time points of 12, 24 and 48 hours (F=15.45-12H: F=12.63-24H: F=7.67-48H). The difference in mean Pethidine requirement in all 3 study groups were statistically significant at 3 time points of 12, 24 and 48 hours (F=20.71-12H: F=14.4-24H:F=10.52-48H). The difference in mean NSAID requirement in all 3 study groups at 24-and 48-hour study points studied were statistically significant (F=5.98-24H: F=8.07-48H). Conclusions: In abdominal hysterectomy the pain score, Pethidine and NSAID requirement was less, in participants who received an USS TAP block and an Open TAP block as a post-operative pain relief method when compared with participants who did not receive either. However, the data did not confirm that one TAP block is statistically superior to other. More detail experimental studies should be planned to evaluate the effectiveness of post-operative pain relief of TAP blocks during open abdominal hysterectomy and TAP blocks compared with existing post-operative pain relief protocols.

show abstract

Analgesic efficacy of laparoscopic-guided transverse abdominis plane block using liposomal bupivacaine in bariatric surgery

Cited by 29 publications

References 12 publications

The Efficacy of Transversus Abdominis Plane Block for Abdominal Hysterectomy Post-operative Analgesia

The Efficacy of Transversus Abdominis Plane Block for Abdominal Hysterectomy Post-operative Analgesia

Reducing Opioid Dependence and Improving Patient Experience for Living Kidney Donors with Transversus Abdominis Plane Block

Determine the effectiveness of post-operative pain management of ultrasound guided transversus abdominis plane block vs open internal transversus abdominis plane block following abdominal hysterectomy a randomized controlled study

Contact Info

Product

Resources

About