Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study

Tran, Tuyen M. N.; Ivanusic, Jason J.; Hebbard, Peter; Barrington, Michael J.

doi:10.1093/bja/aen344

Cited by 298 publications

(206 citation statements)

References 9 publications

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“…We considered using a transversus abdominis plane block [1,2] to provide analgesia; however, if conventionally performed, it would only provide a reliable block for incisions to the level of T8. Following a literature search an alternative technique described by Hebbard [3,4], the subcostal transversus abdominis plane block, used to provide effective analgesia for a cholecystectomy incision, was chosen as a potential solution.…”

Section: Subcostal Transversus Abdominis Plane Blockmentioning

confidence: 99%

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Subcostal transversus abdominis plane block

O’Connor¹,

Renfrew²

2009

Anaesthesia

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Section: Subcostal Transversus Abdominis Plane Blockmentioning

confidence: 99%

“…The procedure is safe and effective in the shortterm; long-term outcome data are emerging [4]. High-risk patients with concomitant illnesses not suitable for surgical aortic valve replacement may now be offered transcatheter aortic valve implantation.…”

Section: Peri-operative Echocardiographic Diagnosis Of Aortic Stenosismentioning

confidence: 99%

Subcostal transversus abdominis plane block

O’Connor¹,

Renfrew²

2009

Anaesthesia

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“…1 Since then, numerous variations of this approach have been suggested to overcome the significant variability of local anesthetic spread demonstrated in cadaveric studies. [2][3][4] In recent years, TAP block has gained popularity as an effective pain relief technique in patients undergoing a variety of abdominal operations. An increasing number of randomized-controlled trials (RCTs) and case reports in the literature have highlighted the analgesic effectiveness of the TAP block and proposed it as an alternative pain management technique in patients with contraindications to the use of opioids and/or neuraxial anesthesia.…”

mentioning

confidence: 99%

Le bloc dans le plan du muscle transverse de l’abdomen pour réaliser une analgésie postopératoire: revue systématique et méta-analyse des études randomisées contrôlées

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

124

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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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“…4 In our patient, the bulge was mid-abdominal, oblique-oriented from the right lumbar region toward the lateral edge of the rectus abdominis, and wider laterally than medially. A relaxation of the abdominal wall has been reported in herpes zoster and in surgical nerve injuries (i.e., as after kidney surgery) but only when all three horizontal muscles of the abdominal wall (i.e., the internal and external oblique and the transversus abdominis) are denervated and atrophic.…”

Section: To the Editormentioning

confidence: 48%

Transient abdominal motor block after a transversus abdominis plane block in an elderly patient

Bortolato

Ori

Freo

2015

Can J Anesth/J Can Anesth

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Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study

Abstract: This anatomical study shows that an ultrasound-guided TAP injection cephalad to the iliac crest is likely to involve the T10-L1 nerve roots, and implies that the technique may be limited to use in lower abdominal surgery.

Cited by 298 publications

References 9 publications

Subcostal transversus abdominis plane block

Subcostal transversus abdominis plane block

Le bloc dans le plan du muscle transverse de l’abdomen pour réaliser une analgésie postopératoire: revue systématique et méta-analyse des études randomisées contrôlées

Transient abdominal motor block after a transversus abdominis plane block in an elderly patient

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