Comparison between ultrasound-guided transversus abdominis plane and conventional ilioinguinal/iliohypogastric nerve blocks for day-case open inguinal hernia repair

Aveline, Christophe; Hétêt, Hubert Le; Roux, Alain; Vautier, Pierre; Cognet, Fabrice; Vinet, E; Tison, C; Bonnet, Francis

doi:10.1093/bja/aeq363

Cited by 173 publications

(136 citation statements)

References 31 publications

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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%

“…In inguinal hernia surgery and appendectomy, compared with the control group, the overall analysis showed that the TAP block reduced the six-hour pain score 20,30,31,39 by 2.5 (95% CI, -4.7 to -1.2; P = 0.001) and the 12-hr pain score 20,30,31,39,48 by 3.9 (95% CI, -5.0 to -2.9; P\0.001) (Fig. 6).…”

Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 97%

“…In one study, 48 273 adults scheduled for inguinal hernia repair were randomly allocated to receive either US-guided TAP block or IIN block by a loss-ofresistance technique. Patients who received TAP block expressed significantly less pain at 12 hr (P = 0.001) and 24 hr (P = 0.013).…”

Section: Transversus Abdominal Plane Block Vs Ilioinguinal/ Iliohypogmentioning

confidence: 99%

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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

130

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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%

Section: Transversus Abdominal Plane Block In Appendectomy and Inguinmentioning

confidence: 97%

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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

130

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“…A survey done about on 5000 patients found that 34.2% of patients visiting clinic have degenerative diseases and the second largest 22.5% of patients have chronic pain following the surgical procedure [1]. International Association for the study of pain (IASP) defines chronic pain as pain without apparent biological value that has persisted beyond the normal tissue; healing time is usually considered 3 months, however when it comes to CPOP, the working definition as mentioned in Table 1 written by Marcae and Davies, which is adopted and still frequently used [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of Transverse Abdominis Plane Block on Chronic Post-Operative Pain—A Review

Lamichhane¹,

Yang²,

Ma³

2017

OJAnes

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Chronic post-operative pain is a recognized adverse consequence of surgery; managing and preventing it are always a better choice. Proper choice of Anesthetic technique, use of combined anesthesia and pre-emptive analgesia may prevent and decrease the incidence of chronic post-operative pain. Transverse abdominis plane block (TAP Block) is a regional anesthesia technique following abdominal surgeries which involve injection of a large amount of local anesthetics in TAP, an anatomical space between the internal oblique and transverse abdominis muscle. The aim of this review is to show the effect and uses of TAP block as a combined anesthesia and multimodal analgesia in preventing chronic post-operative pain.

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“…[7] The transversus abdominis plane (TAP) block, a field block, has subsequently been used for postoperative pain relief in several abdominal surgeries such as large bowel resection, [8] open appendectomy, [9] retropubic prostatectomy, [10] hernia repair, [11] and cesarean section. [12] The blind technique was difficult and may carries potential risk of possible visceral injury, [13] so TAB block was done with ultrasound guidance To minimize these complication.…”

Section: Introductionmentioning

confidence: 99%

Analgesic Efficacy of Ultra-Sound Guided Transversus Abdominis Plane (Tap) Block With Total Abdominal Hysterectomy

Gawad

Emara

Hameed

et al. 2017

Zagazig University Medical Journal

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Background: Pre-incisional bilateral Ultra-sound guided transverses abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents for postoperative analgesia. The aim of this study is, assess the effectiveness of Ultra-sound guided TAP block on requirement of intraoperative fentanyl and post-operative analgesia in patients undergoing total abdominal hysterectomy. Subjects and Methods: Eighty patients ASA physical status I and II, were randomly allocated into two groups (40 patients each), group TAP: received bilateral Ultra-sound guided TAP block with 20ml bupivacaine 0.25% in each side and group GA: received Ultra-sound guided TAP with same volume of normal saline. both groups given standardized GA. Intra-operative fentanyl requirements and postoperative pain using visual analogue score (VAS) at 30 min.1, 2, 3, 6, 12 and 24 h post-operatively were assessed and if VAS ≥3, patients received i.v. pethidine as a rescue analgesic and time to first request of analgesia was recorded. Results: Intra-operative fentanyl requirement reduced in TAP group compared to GA group; it was 100.4±21.6 and150.3±24.3 mcg respectively. Time to the first analgesic request was also reduced in TAP group compared to GA group; it was112.5±5.4 min.vs.23.4 ± 2.3 min respectively. VAS at most post-operative measurement points and pethidine requirement were reduced in TAP group compared to GA group; (41.7 and 92.3 mg respectively).There were no recorded complications attributed to the TAP block procedure. All TAP group patients were highly satisfied with their postoperative analgesic regimen. Conclusion: TAP block provides effective intra and postoperative analgesia, prolongs time to the first analgesic request and reduces total intra and postoperative analgesic consumption with minimal PONV after total abdominal hysterectomy.

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Comparison between ultrasound-guided transversus abdominis plane and conventional ilioinguinal/iliohypogastric nerve blocks for day-case open inguinal hernia repair

Abstract: Ultrasound-guided TAP block provided better pain control than 'blind' IHN block after inguinal hernia repair but did not prevent the occurrence of chronic pain.

Cited by 173 publications

References 31 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

Effect of Transverse Abdominis Plane Block on Chronic Post-Operative Pain—A Review

Analgesic Efficacy of Ultra-Sound Guided Transversus Abdominis Plane (Tap) Block With Total Abdominal Hysterectomy

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