Analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing open appendicectomy

Niraj, G.; Searle, Aidan; Mathews, Mary S.; Misra, Vivek; Baban, M.; Kiani, Sania Khawar; Wong, Marron

doi:10.1093/bja/aep175

Cited by 275 publications

(243 citation statements)

References 12 publications

(5 reference statements)

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“…6). Compared with the control group, the TAP block reduced the 24-hr pain score 20,30,31,39,48,62 by 1.7 (95% CI, App/IS = appendectomy /inguinal surgery; CD = Cesarean delivery; CI = confidence interval; I 2 = heterogeneity; IAW = inside abdominal wall; TAP = transversus abdominal plane block; US = ultrasound -2.4 to -1.0; P \ 0.001) and 24-hr morphine consumption 30,39,62 by 20.4 mg (95% CI, -29.7 to -11.1; P \ 0.001) ( Table 2).…”

Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 92%

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

131

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Purpose The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. Source We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i.e., placebo, epidural analgesia, intrathecal morphine (ITM), and ilioinguinal nerve block after abdominal surgery]. Meta-analyses were performed on postoperative pain scores at rest at six, 12, and 24 hr (visual analogue scale, 0-10) and on 24-hr opioid consumption. Principal findings In the 51 trials identified, compared with placebo, TAP block reduced the VAS for pain at six hours by 1.4 (95% confidence interval [CI], -1.9 to -0.8; P\0.001), at 12 hr by 2.0 (95% CI, -2.7 to -1.4; P\0.001), and at 24 hr by 1.2 (95% CI, -1.6 to -0.8; P \ 0.001). Similarly, compared with placebo, TAP block reduced morphine consumption at 24 hr after surgery (mean difference, -14.7 mg; 95% CI, -18.4 to -11.0; P \0.001). We observed this reduction in pain scores and morphine consumption in the TAP block group after gynecological surgery, appendectomy, inguinal surgery, bariatric surgery, and urological surgery. Nevertheless, separate analysis of the studies comparing ITM with TAP block revealed that ITM seemed to have a greater analgesic efficacy. Conclusions The TAP block can play an important role in the management of pain after abdominal surgery by reducing both pain scores and 24-hr morphine consumption. It may have particular utility when neuraxial techniques or opioids are contraindicated. RésuméObjectif Le bloc dans le plan du muscle transverse de l'abdomen (ou TAP bloc) a été décrit comme une technique efficace de contrô le de la douleur après une chirurgie abdominale. Nous avons réalisé une revue systématique et une méta-analyse des études randomisées contrô lées (ERC) pour faire un état des lieux du nombre croissant d'études

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Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 92%

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

131

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“…Similar findings have been reported by other researchers demonstrating TAP block to provide excellent pain relief in patients undergoing appendectomy. 2,3,5 Comparable VAS at 30 min (0.65±0.93 and 0.90±1.11) postoperatively in both the groups in our study is most likely due to the residual effect of intraoperatively administered pethidine and paracetamol.…”

Section: Discussionmentioning

confidence: 47%

The Analgesic Effectiveness of Ipsilateral Transversus Abdominis Plane Block in Adult Patients Undergoing Appendectomy: A Prospective Randomized Controlled Trial

Ghimire¹,

Bhattarai²,

Prasad³

et al. 2017

Kathmandu Univ. Med. J.

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“…This was similar to the study performed by Mc Donnell et al [4] in caesarean section delivery where VAS at rest and on movement was significantly low till 12 hours in patients who received TAP block with local anesthetic. Study performed by Niraj et al [8] in open appendicectomy and Neerja Bharti et al [12] in colorectal surgery also showed similar results.…”

Section: Discussionmentioning

confidence: 53%

“…Our study results are comparable with Dawlatly et al [7] who showed 55% decrease in opioid requirement after USG guided TAP block in laparoscopic cholecystectomy. Niraj et al [8] showed 45% decrease in opioid requirement with USG guided TAP block in open appendicectomy. John Carney, McDonnell et al [6] also showed 47% decrease in opioid requirement with TAP block after total abdominal hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies by Hebbard et al [14,15] (posterior TAP block), T. M. Tran (cadaveric study), Dawlathy (Lap cholecystectomy) [7], Niraj et al (open appendicectomy) [8] , Belary et al (caesarean section delivery) [9] , D.J Sandeman (Lap appendicectomy) [11] have all proved that "In plane" USG guidance ensures the exact position of LA between the IOAM and TAM, resulting in improve safety and efficacy.…”

Section: Discussionmentioning

confidence: 99%

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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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Analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing open appendicectomy

Abstract: Ultrasound-guided TAP block holds considerable promise as a part of a balanced postoperative analgesic regimen for patients undergoing open appendicectomy.

Cited by 275 publications

References 12 publications

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

The Analgesic Effectiveness of Ipsilateral Transversus Abdominis Plane Block in Adult Patients Undergoing Appendectomy: A Prospective Randomized Controlled Trial

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

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