Effect of transversus abdominis plane block in combination with general anesthesia on perioperative opioid consumption, hemodynamics, and recovery in living liver donors: The prospective, double‐blinded, randomized study

Erdoğan, Mehmet Ali; Özgül, Ülkü; Uçar, Muharrem; Yalın, Mehmet Rıdvan; Çolak, Yusuf Ziya; Çolak, Cemil; Toprak, Hüseyin

doi:10.1111/ctr.12931

Cited by 29 publications

(24 citation statements)

References 21 publications

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“…In this study, we found that TAPB and RSB significantly decreased intraoperative remifentanil consumption. This result was consistent with that of a previous study [26]. There are many afferent nerves that transfer invasive signals from the anterior abdominal wall and lie in potential spaces of the sheath of the rectus abdominis, internal oblique and transversus abdominis muscles.…”

Section: Discussionsupporting

confidence: 93%

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

et al. 2020

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Background: Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery. Methods: A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine/ morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and offbed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded. Results: Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores. Conclusions: The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery.

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Section: Discussionsupporting

confidence: 93%

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

et al. 2020

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“…A previous meta-analysis of the efficacy of TAP block demonstrated that it reduced the requirement for postoperative opioids and associated side-effects, and provided more effective pain relief ( 24 ), suggesting that there may be a role for TAP blocks as part of an effective multimodal pain regimen. Erdogan et al ( 5 ) demonstrated that there was significantly lower remifentanil consumption and anesthesia recovery time, but no significant differences in desflurane consumption in liver transplant donors who received TAP block, compared with donors who didn't receive TAP block. Tsuchiya et al ( 6 ) reported a similar sparing-effect of TAP block on sevoflurane and fentanyl use in abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Transversus abdominis plane (TAP) block is a regional anesthesia technique that has been widely used in abdominal surgery ( 3 , 4 ). TAP block provides effective postoperative analgesia following abdominal surgery, and it can be a useful strategy to reduce perioperative opioid consumption, maintain intraoperative hemodynamic stability and promote early recovery from anesthesia ( 5 , 6 ). In addition, it is simple to perform TAP block, and there are minimal procedure-associated complications ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Transversus abdominis plane block reduces remifentanil and propofol consumption, evaluated by closed‑loop titration guided by bispectral index

Wang²,

Sun

et al. 2018

Exp Ther Med

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The present prospective, randomized, double-blind study aimed to determine the impact of transversus abdominis plane (TAP) block on propofol and remifentanil consumption, when administered by closed-loop titration guided by processed electroencephalography, i.e., bispectral index (BIS) values. Following institutional review board approval, 60 patients were scheduled for laparoscopic colectomy under general anesthesia. Patients were randomly assigned to receive bilateral TAP block with 20 ml 0.375% ropivacaine (TAP group) or 20 ml 0.9% saline [control (CON) group]. General anesthesia was maintained with propofol and remifentanil administration using closed-loop titration guided by BIS values. The primary outcome was perioperative propofol and remifentanil consumption. The secondary outcomes were hypertensive or hypotensive events requiring treatment, recovery time in PACU and time to first rescue analgesia following surgery. A total of 58 patients participated in the present study. At similar depths of anesthesia, as measured by BIS during the maintenance phase (45–55), patients who received TAP blocks required less propofol (4.2±1.3 vs. 5.5±1.6 mg/kg/h; P<0.001) and remifentanil (0.16±0.05 vs. 0.21±0.05 µg/kg/min; P<0.001). Time to extubation was significantly shorter in the TAP group (9.8±3.2 min) than in the CON group (14.2±4.9 min) (P<0.05). The requirement to treat hemodynamic change was also significantly lower (P<0.05). Pain score at 2 h after surgery was also significantly reduced in the TAP group compared with the CON group (P<0.05), whereas the time to first rescue analgesia was delayed in patients who received TAP block (P<0.05). Postoperative nausea and vomiting occurred at comparable rates in each group (P>0.05). In conclusion, TAP block combined with general anesthesia reduced propofol and remifentanil consumption, shortened time to tracheal extubation and promoted hemodynamic stability in laparoscopic colectomy.

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“…Many methods can provide effective postoperative analgesia for patients receiving LLS, including spinal morphine, 33 intravenous patient control analgesia, 34 intra-articular injection of LA or opioid, 35 femoral nerve block both single shot or continuous infusion via catheter, 36 ultrasound-guided FICB, 37 and oral analgesic medication (i.e., nonsteroidal anti-inflammatory drugs [NSAIDs], acetaminophen) as multimodal analgesia. 38 Among these, FICB is injected through the iliac fascia cavity, which is constructed with the fascia as prezone and the iliopsoas as posterior.…”

Section: Discussionmentioning

confidence: 99%

Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis

Yang¹,

Li²,

Chen³

et al. 2017

JPR

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BackgroundThe analgesic effect of fascia iliaca compartment block (FICB) versus no block (NB) after lower limb surgery (LLS) is still controversial, so we performed this meta-analysis.Materials and methodsBy searching the PubMed, Embase and the Cochrane Library (last update by July 20, 2017), randomized controlled trials comparing the analgesic effect of FICB versus NB in patients receiving LLS were identified. The primary outcome was the pain scores at 4, 12, and 24 h after LLS. The dosage of morphine at 24 h was also collected. The side effect of anesthesia was assessed according to the occurrence rate of postoperative nausea and vomiting.ResultsData from 7 clinical trials that included 508 patients were summarized. The results showed that patients receiving FICB had lower pain scores at 4 h (mean difference [MD]=−1.17; 95% CI=−2.30 to −0.05; P=0.041), 12 h (MD=−0.41; 95% CI=−0.76 to −0.05; P=0.026) and 24 h (MD=−0.96; 95% CI=−1.77 to −0.15; P=0.020) after LLS. Besides, FICB could reduce the dosage of morphine at 24 h (MD=−2.06; 95% CI=−3.82 to −0.30; P=0.022) and the incidence of postoperative nausea and vomiting (relative risk rate=0.44, 95% CI=0.24–0.80, P=0.008).ConclusionCompared with NB, FICB is an effective and safe method for alleviating the pain after LLS. More high-quality randomized controlled trials are needed to confirm this finding.

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Effect of transversus abdominis plane block in combination with general anesthesia on perioperative opioid consumption, hemodynamics, and recovery in living liver donors: The prospective, double‐blinded, randomized study

Abstract: Combining subcostal TAP blocks with general anesthesia significantly reduced perioperative and postoperative opioid consumption, provided shorter anesthesia recovery time, and length of hospital stay in living liver donors.

Cited by 29 publications

References 21 publications

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

Transversus abdominis plane block reduces remifentanil and propofol consumption, evaluated by closed‑loop titration guided by bispectral index

Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis

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