Comparison of Transversus Abdominis Plane Block and IV Patient-Controlled Analgesia after Lower Abdominal Surgery

Erbabacan, Emre; Kendigelen, Pınar; Köksal, Güniz Meyancı; Tütüncü, Çiğdem; Ekici, Birsel; Şeker, Tuğçe Barça; Kaya, Güner; Altındaş, Fatiş

doi:10.5152/tjar.2014.82788

Cited by 9 publications

(11 citation statements)

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“…The superiority of PCA over TAP block regarding pain relief and patient satisfaction might be due to the effect of combinations of PCA drugs systemically, affecting visceral pain, in contradiction with TAP block, which acts on somatic pain only in the anterior abdominal wall. On the contrary to our results, Erbabacan et al (2015) concluded that, in lower abdominal surgeries, 30 mL of TAP block is as effective as intravenous PCA in pain treatment. In addition, comparing intravenous PCA with TAP block revealed that the latter is regarded as a more superior approach since it can avoid the systemic actions of morphine used for PCA and as its analgesic effect starts earlier (Erbabacan et al 2015).…”

Section: Discussioncontrasting

confidence: 99%

“…On the contrary to our results, Erbabacan et al (2015) concluded that, in lower abdominal surgeries, 30 mL of TAP block is as effective as intravenous PCA in pain treatment. In addition, comparing intravenous PCA with TAP block revealed that the latter is regarded as a more superior approach since it can avoid the systemic actions of morphine used for PCA and as its analgesic effect starts earlier (Erbabacan et al 2015). However, this study was carried out on lower abdominal surgeries, not cesarean sections that exclude the pain from postoperative uterine contractions.…”

Section: Discussioncontrasting

confidence: 99%

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The new trending pain-free cesarean section: TAP block versus IV PCA

et al. 2021

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Background Women's pain satisfaction post-cesarean section remains a challenge. Accurate assessment of pain severity of post-cesarean section helps to choose the most appropriate anesthetic approach, drug, and dose, as well as improvement of treatment of postoperative pain. Our objective was to compare the efficacy of ultrasound-assisted transversus abdominis plane (TAP) block versus IV patient-controlled analgesia (PCA) in the first 24 h postoperative in women who underwent cesarean section. The primary outcome was postoperative pain at 2, 4, 6, 12, and 24 h. The secondary outcomes were intestinal mobility, early mobilization, nausea, vomiting, heart rate, and respiratory rate. Results A cross-sectional study has been conducted on 70 women who are planned for elective cesarean section. They were divided into 2 groups; “group A” (n = 35), women who received TAP block, and “group B” (n = 35), those who received PCA. Pain score, heart rate, respiratory rate, intestinal motility, nausea, and vomiting have been assessed 2, 4, 6, 12, and 24 h postoperatively. The degree of pain was significantly lower in “group B” than in “group A” in all time intervals (p < 0.001). Heart rate was significantly higher in women in “group B” compared to those in “group A” only at 2 and 4 h postoperative (p < 0.001). Nausea and vomiting were also significantly higher in women in “group B” compared to those in “group A” (p value 0.03 and 0.04, respectively). Regarding intestinal motility, it was audible in “group A” earlier than in “group B.” Conclusions Both TAP block and PCA are effective in postoperative pain relief after cesarean section; however, PCA is more superior, especially for visceral pain. Nevertheless, TAP block has the privilege of avoiding systemic action of opioids used in PCA. PCA can easily be applied while TAP block needs more training and an intraoperative ultrasound machine. Complications and side effects of both were minimal when adjusting the doses.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

The new trending pain-free cesarean section: TAP block versus IV PCA

et al. 2021

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“…The TAP block has significantly long-lasting analgesia effects compared to local anesthetic infiltration at the surgical site 18. The efficacy of the TAP block is comparable to IV morphine patient-controlled analgesia when used for lower abdominal surgeries but with fewer ileus and sedation events 19. Its analgesic efficacy depends on the approach used for injecting local anesthetic.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Postoperative Analgesia in Patients Undergoing Ileostomy Closure with and Without Dual Transversus Abdominis Plane (TAP) Block: A Randomized Controlled Trial

Nair

Amula

Naik

et al. 2019

Rambam Maimonides Med J

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Background and AimsMultimodal analgesia comprising opioid, paracetamol, and non-steroidal anti-inflammatory drugs is used for managing postoperative surgical pain after ileostomy closure (IC). We investigated the efficacy of unilateral dual transversus abdominis plane (TAP) block to reduce morphine consumption in the first 24 hours along with a reduction in visual analogue score for pain and in postoperative nausea/vomiting.MethodsThis was a single-center, investigator-initiated, prospective, parallel-group, placebo-controlled randomized study involving patients undergoing IC under general anesthesia. We recruited 55 patients in two groups: 28 in a TAP group and 27 in a placebo group. The TAP group patients received 30 mL of 0.375% bupivacaine: 15 mL by a posterior TAP approach and 15 mL by a subcostal approach using ultrasonography. Patients in the placebo group received 30 mL normal saline (placebo) using the same approaches. Blocks were administered at the end of surgery before extubation. To monitor for the primary outcome—24-hour morphine consumption for both groups—patients were transferred to a high-dependency unit. The secondary outcome was to compare postoperative nausea/vomiting in both groups.ResultsThe demographic data, gender distribution, ASA physical status, duration of surgery, and time of first morphine dose was comparable in both groups. The 24-hour morphine consumption was 3.29±2.78 mg and 9.23±2.94 mg for the TAP and placebo groups, respectively, which was statistically significant (P=0.001).ConclusionDual TAP block reduces opioid consumption in the first 24 hours after an IC and can facilitate early recovery with less adverse effects seen than with opioids and NSAIDs.

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“…Opioidlerin kullanımı-na bağlı sedasyon, solunum depresyonu, kaşıntı, bulantı-kusma ile nöroaksiyal yöntemlerin olası parapleji veya kanama gibi komplikasyonları, bu iki yöntemin en büyük dezavantajı gibi görünmektedir. Transversus abdominis plan (TAP) bloğu, özellikle çocuklarda kaudal ve epidural analjezinin alternatifi olarak intraoperatif ve postoperatif analjezi sağlayan bir rejyonal anestezi tekniğidir (2)(3)(4) . TAP blok, çocuklarda alt batın ve pelvik cerrahilerde epidural analjezinin alternatifi olarak multimodal postoperatif analjezik konseptin bir parçası olarak etki göstermiştir (3) .…”

Section: Introductionunclassified

The comparison of ultrasonography guided transversus abdominis plane block and wound infiltration for pediatric inguinal hernia repair: Randomised clinical study

Ahişkalıoğlu¹,

Yayık²,

Ekinci³

et al. 2017

BUCH

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ÖZAmaç: Transversus abdominis plan (TAP) blokun postoperatif analjezik etkinliği abdominal cerrahi geçirecek olan hastalarda tartışmalıdır. Bu çalışmanın amacı, inguinal herni tamiri yapı-lan pediyatrik hastalarda ultrasound eşliğinde yapılan TAP blok ile yara yeri infiltrasyonunun analjezik etkinliğini karşılaştırmaktır. Yöntem: Etik onam alındıktan sonra 3-8 yaş arası, tek taraflı inguinal herni onarımı yapılacak olan 60 hasta randomize olarak TAP blok (Grup TAP, n=30) veya yara yeri infiltrasyonu (Grup infiltrasyon, n=30) olarak iki gruba ayrıldı. TAPB grubuna ultrason eşliğinde 0,5 ml/kg olacak şekilde %0,25'lik bupivakain, Grup C'ye ise 0,5 ml/kg olacak şekilde 0,25'lik bupivakain cerrahi öncesi uygulandı. Ağrı skorları (Wong-Baker Yüz Skalası), aile memnuniyeti, blok komplikasyonları ve ek analjezik gereksinimi kaydedildi. Bulgular: İnfiltrasyon grubu ile karşılaştırıldığında, ilk 12 saatteki ağrı skorları TAPB grubunda istatistiksel olarak daha düşüktü (p<0,05). Ek analjezik gereksinimi TAPB grubunda, infiltrasyon grubuna göre istatistiksel olarak daha düşüktü (10/30 vs 18/30 sırasıyla, p=0,038). Aile memnuniyeti TAPB grubunda, Grup infiltrasyona göre istatistiksel olarak daha fazlaydı (p<0,001). Sonuç: TAP bloğun postoperatif analjezik etkinliği tartışmalı olmasına rağmen, pediyatrik inguinal herni tamirinde ultrason eşliğinde uygulanan TAP blok yara yeri infiltrasyonuna göre ağrı skorlarını anlamlı derecede azaltmaktadır.Anahtar kelimeler: Ultrasonografi, transversus abdominis plan bloku, inguinal herni, postoperatif analjezi ABSTRACT Objective: Postoperative analgesic effect of transversus abdominis plane (TAP) block in patients undergoing abdominal surgery has been debatable. The aim of this study was to compare the analgesic effect of ultrasound guided TAP block and wound infiltration in pediatric patients undergoing inguinal herniorrhaphy. Methods: After ethical board approval, 60 children between 3 and 8 years of age undergoing unilateral inguinal hernia repair were randomized to TAP block (Group TAP, n=30) or to wound infiltration (Group infiltration, n=30). Group TAPB received ultrasound-guided TAP block with 0.25% bupivacaine 0.5 ml/kg and Group C received wound infiltration with 0.25% bupivacaine 0.5 ml/kg before surgery. Pain scores (Wong-Baker Faces), parental satisfication, block complications and additional analgesia requirements were recorded. Results: Compared with the infiltration group, the pain scores were statistically lower in the TAPB group during the first 12 hours (p<0.05). The additional analgesia requirement was statistically lower in the TAPB group than Group infiltration group (10/30 vs 18/30 respectively, p=0.038). Parental satisfaction was statistically higher in the Group TAPB than Group infiltration (p<0.001). Conclusion: Despite the postoperative effect of TAP block is debatable; ultrasound-guided TAP block reduces postoperative pain after pediatric inguinal hernia repair compared to wound infiltration.

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Comparison of Transversus Abdominis Plane Block and IV Patient-Controlled Analgesia after Lower Abdominal Surgery

Abstract: Transversus abdominis plane block is effective as IV morphine-PCA in postoperative pain therapy in lower abdominal surgery, when given in a 30-mL volume. It may be preferable to IV-PCA, as the analgesic effect starts earlier and decreases the systemic effect of the morphine used in PCA.

Cited by 9 publications

References 10 publications

The new trending pain-free cesarean section: TAP block versus IV PCA

The new trending pain-free cesarean section: TAP block versus IV PCA

Comparison of Postoperative Analgesia in Patients Undergoing Ileostomy Closure with and Without Dual Transversus Abdominis Plane (TAP) Block: A Randomized Controlled Trial

The comparison of ultrasonography guided transversus abdominis plane block and wound infiltration for pediatric inguinal hernia repair: Randomised clinical study

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