Efficacy of a laparoscopically delivered transversus abdominis plane block technique during elective laparoscopic cholecystectomy; a prospective double blind randomized trial

Elamin, Ghassan; Hamid, Hytham K. S.; Waters, Peadar S; O'Keeffe, Hannah M.; Duggan, Mechelle; Khan, Waqar; Waldron, R.; Barry, Kevin; Khan, Iqbal

doi:10.1016/j.jamcollsurg.2014.07.624

Cited by 12 publications

(30 citation statements)

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“…A review of studies up to early 2016 of peripheral nerve blocks again demonstrated a lack of data [211]. There have been more recent RCTs indicating the benefits of TAP blocks in abdominal surgery in multiple specialties including gynaecologic, general, bariatric and transplant surgery [262][263][264][265][266] and also specifically in colorectal surgery with less opioid use, faster resumption of GI tract function and recovery [267,268] although others have not shown benefits [269]. One major weakness with abdominal blocks is short duration.…”

Section: Abdominal Wall Blocksmentioning

confidence: 99%

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

et al. 2018

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Background: Transanal dissection of the rectum has been recently introduced for ileal pouch-anal anastomosis (IPAA) in UC showing promising results. Thanks to the precise identification of the rectotomy site the risk of long rectal stump is avoided, and a single stapled anastomosis is performed easily. The aim of this study is to analyze our initial experience of transanal IPAA (Ta-IPAA), considering postoperative complications and medium-term functional outcomes. Methods: Our Center has experienced the transanal approach for proctectomy and IPAA since October 2018. All patients underwent Enhanced Recovery After Surgery (ERAS) protocol. Postoperative complications occurring within 30 days after surgery were taken into consideration. Results: Until March 2019, 8 patients underwent Ta-IPAA. In all cases the laparoscopic approach was performed during the transabdominal phase; abdominal drainage was never used. At the time of the pouch construction a defunctioning ileostomy was created in all patients. Stoma closure was performed in all cases at a median time of 6 months after surgery. Postoperative complications occurred in only one patient, who showed rectal bleeding. There were no cases of anastomotic leakage. Medium-term functional outcomes were determined prospectively by a validated questionnaire (Cleveland Global Quality of Life). Fecal incontinence for liquid or solid stool, restriction in work and social genitourinary and sexual functions were also investigated. Conclusions: In our experience, Ta-IPAA provided good short and medium-term functional results in UC. Background Restorative proctocolectomy is widely adopted in the treatment of ulcerative colitis ,, , as well as in other inflammatory and neoplastic conditions, requiring an ileal pouch-anal anastomosis (IPAA) to reconstruct gastrointestinal continuity to the anus. Conventionally, either the laparoscopic or the open approach can be employed to gain rectal dissection and creation of ileal pouch-anal anastomosis. Pouch-anal anastomosis is usually made using a stapler, leaving a 2 cm rectal cuff in order to preserve continence and to reduce the risk of inflammatory recurrence or dysplasia. The dissection of the last centimeters of the rectum, rectum resection and ileal pouch-anal anastomosis could be demanding from a technical point of view due to narrow pelvic space and cross stapling of the distal part of the rectum is often challenging for surgeons. Transanal total mesorectal excision (TaTME) has been recently described in rectal cancer treatment, with potential technical and oncologic advantages compared to transabdominal approach. The transanal approach for the proctectomy has been described also in IPAA since 2015, showing feasibility and potential technical advantages; some series ,,, and initial comparative studies have been published , , showing a not increased rate of postoperative morbidity, equivalent quality of life and functional results. The aim of our study is to analyze a single centre experience of transanal IPAA (Ta-IPAA), examining e...

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Section: Abdominal Wall Blocksmentioning

confidence: 99%

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

et al. 2018

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“…Afterward, Chetwood et al [23] used a similar method following laparoscopic nephrectomy which was safe and time saving. In addition, laparoscopic-guided TAP block has reduced postoperative pain scores after laparoscopic cholecystectomy [24,25] and laparoscopic ventral hernia repair [26].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic-guided transversus abdominis plane block versus trocar site local anesthetic infiltration in gynecologic laparoscopy

et al. 2018

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Background: Relieving postoperative pain and prompt resumption of physical activity are of the utmost importance for the patients and surgeons. Infiltration of local anesthetic is frequently used methods of pain control postoperatively. Laparoscopically delivered transversus abdominis plane block is a new modification of ultrasound-guided transversus abdominis plane block. This study was conducted to compare the efficacy of laparoscopic-guided transversus abdominis plane block with trocar site local anesthetic infiltration for pain control after gynecologic laparoscopy. Results: No statistically significant difference between the two groups in mean visual analogue scale at 1, 18, and 24 h (P = 0.34, P = 0.41, and P = 0.61, respectively), while the mean visual analogue scale was significantly lower in the laparoscopic-guided transversus abdominis plane block group than in the trocar site local anesthetic infiltration group at 3, 6, and 12 h (P = 0.049, P = 0.011, and P = 0.042, respectively). No statistically significant difference was observed in the cumulative narcotics consumed at 3 h (P = 0.52); however, women with transversus abdominis plane block have consumed significantly less amount of narcotics than women with trocar site infiltration at 6, 12, and 24 h (P = 0.04, P = 0.038, and P = 0.031 respectively). Patient satisfaction was significantly higher in the laparoscopic-guided transversus abdominis plane block group (P = 0.035). Conclusion: Laparoscopic-guided transversus abdominis plane block is more effective in reduction of both pain scores in the early postoperative period and the cumulative narcotics consumption than trocar site local anesthetic infiltration in gynecologic laparoscopy.

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“…PONV Incidence and Patient Satisfaction. Four studies reported PONV incidence [10,13,20,23], and the overall effect of the pooled studies showed that PONV incidence was not different between groups (OR = 0:97, 95% CI (0.66, 1.43), P = 0:88), and the heterogeneity was low (I 2 = 0%) ( Figure 16). Three studies reported that patient satisfaction with TAP was higher than that with WI (MD = 1:27, 95% CI (0.22, 2.32), P = 0:02), but the heterogeneity was high (I 2 = 89%) ( Figure 17).…”

Section: Time Until the First Rescuementioning

confidence: 99%

“…BioMed Research International including general surgeries [10][11][12][13][14][15][16], gynecological and obstetric surgeries [17][18][19][20][21][22], urinary surgeries [23], and nephrology surgeries [24].…”

Section: Flowchart Of the Literature Search And Studymentioning

confidence: 99%

Transversus Abdominis Plane Block versus Wound Infiltration with Conventional Local Anesthetics in Adult Patients Underwent Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Cai

Gao

Chen

et al. 2020

BioMed Research International

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Background. How to effectively control the postoperative pain of patients is extremely important to clinicians. Transversus abdominis plane (TAP) block is a novel analgesic method reported to greatly decrease postoperative pain. However, in many areas, there still exists a phenomenon of surgeons using wound infiltration (WI) with conventional local anesthetics (not liposome anesthetics) as the main means to decrease postoperative pain because of traditional wisdom or convenience. Here, we compared the analgesic effectiveness of the two different methods to determine which method is more suitable for adult patients. Materials and methods. A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing TAP block and WI without liposome anesthetics in adult patients were performed. Frequently used databases were extensively searched. The main outcomes were postoperative pain scores in different situations (at rest or during movement) and the time until the first use of rescue analgesics. The secondary outcomes were postoperative nausea and vomiting (PONV) incidence and patient satisfaction scores. Results. Fifteen studies with 983 participants met the inclusion criteria and were included in the present study. The heterogeneity in the final analysis regarding the pain score was low to moderate. The major results of the sensitivity analysis were stable. WI had the same analgesic effect as TAP block only at the one-hour postoperative time point (mean difference=−0.32, 95% confidence interval (-0.87, 0.24), P=0.26) and was associated with a shorter time until the first rescue analgesic and poorer patient satisfaction. Conclusion. TAP block results in a more effective and steady analgesic effect than WI with conventional local anesthetics in adult patients from the early postoperative period and obtains higher patient satisfaction.

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Efficacy of a laparoscopically delivered transversus abdominis plane block technique during elective laparoscopic cholecystectomy; a prospective double blind randomized trial

Cited by 12 publications

References 0 publications

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

Laparoscopic-guided transversus abdominis plane block versus trocar site local anesthetic infiltration in gynecologic laparoscopy

Transversus Abdominis Plane Block versus Wound Infiltration with Conventional Local Anesthetics in Adult Patients Underwent Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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Efficacy of a laparoscopically delivered transversus abdominis plane block technique during elective laparoscopic cholecystectomy; a prospective double blind randomized trial

Cited by 12 publications

References 0 publications

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018

Laparoscopic-guided transversus abdominis plane block versus trocar site local anesthetic infiltration in gynecologic laparoscopy

Transversus Abdominis Plane Block versus Wound Infiltration with Conventional Local Anesthetics in Adult Patients Underwent Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018