Laparoscopic-Guided Transversus Abdominis Plane (TAP) Block as Part of Multimodal Analgesia in Laparoscopic Roux-en-Y Gastric Bypass Within an Enhanced Recovery After Surgery (ERAS) Program: a Prospective Randomized Clinical Trial

Ruíz-Tóvar, Jaime; García, Alejandro; Ferrigni, Carlos; González, Juan; Levano-Linares, César; Jiménez-Fuertes, Montiel; Llavero, Carolina; Durán, Manuel

doi:10.1007/s11695-018-3376-8

Cited by 44 publications

(23 citation statements)

References 29 publications

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“…Numerous studies indicate that TAP blocks can effectively provide analgesia following laparoscopic abdominal surgery, thus increasing their popularity in ERAS protocols. 7 – 10 , 27 – 31 However, anesthesia and pain medicine literature continue to question the utility of TAP blocks in these cases. 3 , 11 This discrepancy in evidence, or interpretation of evidence, makes it difficult to identify best clinical practices.…”

Section: Transversus Abdominis Plane Blocksmentioning

confidence: 99%

“… 51 Studies have demonstrated improvements in the components of ERAS protocols with TAP blocks. 7 – 10 However, a large meta-analysis and comprehensive systematic review challenge these proposed benefits. 3 , 11 …”

Section: Clinical Impactmentioning

confidence: 99%

“…Numerous studies suggest that TAP blocks should be incorporated into ERAS protocols. 7 – 10 In fact, a review of laparoscopic urological surgery concluded that TAP block should be “an indispensable component” of these protocols. 10 However, recent reviews in major anesthesia journals remain skeptical and suggest that TAP block may not offer clinically significant benefits in analgesia following laparoscopic abdominal surgery when added to multimodal analgesia, as presented in Table 1 .…”

Section: Introductionmentioning

confidence: 99%

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<p>Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review</p>

Jones¹,

Aldwinckle²

2020

LRA

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Laparoscopic abdominal surgery has become a mainstay of modern surgical practice. Postoperative analgesia is an integral component of recovery following laparoscopic abdominal surgery and may be improved by regional anesthesia or intravenous lidocaine infusion. There is inconsistent evidence supporting the use of interfascial plane blocks, such as transversus abdominis plane (TAP) blocks, for patients undergoing laparoscopic abdominal surgery as evidenced by variable patterns of local anesthetic spread and conflicting results from studies comparing TAP blocks to local anesthetic infiltration of laparoscopic port sites and multimodal analgesia. Quadratus lumborum (QL) and erector spinae plane (ESP) blocks may provide greater areas of somatic analgesia as well as visceral analgesia, which may translate to more significant clinical benefits. Aside from the locations of the surgical incisions, it is unclear what other factors should be considered when choosing one regional technique over another or deciding to infuse lidocaine intravenously. We reviewed the current literature in attempt to clarify the roles of various regional anesthesia techniques for patients undergoing laparoscopic abdominal surgery and present one possible approach to evaluating postoperative pain.

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Section: Transversus Abdominis Plane Blocksmentioning

confidence: 99%

Section: Clinical Impactmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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<p>Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review</p>

Jones¹,

Aldwinckle²

2020

LRA

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“…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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“…2 More recently, Ruiz-tovar and colleagues replicated our results using a 6-point technique in patients undergoing Roux-en-Y gastric bypass within an enhanced recovery after surgery program. 3 Saber et al 1 used an US-guided two-point technique at the midclavicular line. Although the study was well-designed and adequately powered, no significant differences were noted in the outcome measures except for postoperative pain score at 3 hours after surgery.…”

Section: Dear Editormentioning

confidence: 99%

Anatomical considerations for transversus abdominis plane block in laparoscopic surgery

Hamid¹,

Khan

2020

The American Journal of Surgery

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Laparoscopic-Guided Transversus Abdominis Plane (TAP) Block as Part of Multimodal Analgesia in Laparoscopic Roux-en-Y Gastric Bypass Within an Enhanced Recovery After Surgery (ERAS) Program: a Prospective Randomized Clinical Trial

Abstract: ClinicalTrials.gov Identifier: NCT03203070.

Cited by 44 publications

References 29 publications

<p>Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review</p>

<p>Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review</p>

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

Anatomical considerations for transversus abdominis plane block in laparoscopic surgery

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