&lt;p&gt;Anesthetic techniques: focus on transversus abdominis plane (TAP) blocks&lt;/p&gt;

Mallan, Deepanshu; Sharan, Sandeep; Saxena, Sumi; Singh, Tapas Kumar; Faisal, F.

doi:10.2147/lra.s138537

Cited by 20 publications

(14 citation statements)

References 31 publications

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“…A number of authors have confirmed the safety of the postoperative infusion of lidocaine in doses ranging from 3,200mg to 6,000mg over a 48 hour period. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In the past few years, the use of interfacial plane blocks has been more and more advocated, 20 including erector spinae plane blocks (ESPB) for thoracic surgery, [21][22][23][24][25] pectoralis and serratus blocks for breast surgery [26][27][28][29] and quadratus lumborum (QL) blocks for abdominal surgery, 30 Intravenous lidocaine (IV lido) infusions have been demonstrated to be an effective technique for postoperative analgesia in several different types of surgery, including abdominal, [31][32][33][34] thoracic, 35,36 and spine. 37,38 We hypothesized that SNBs followed by IV lido would be as effective as CNBs.…”

Section: Introductionmentioning

confidence: 99%

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Single Injection Nerve Blocks Plus IV Lidocaine Infusions as an Alternative to Continuous Nerve Blocks for Perioperative Pain Management: A retrospective review

Громов

Kearns

Chelly

2022

Preprint

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Purpose: Continuous nerve blocks (CNBs) and intravenous lidocaine infusions (IV Lido) represent an effective approach to perioperative pain management. We hypothesized that a single injection nerve block (SNB) plus intravenous lidocaine infusion (IV Lido) would be as effective as CNBs. Furthermore, since recently, the use of facial plane blocks are increasingly advocated, we compared CNBs vs SNBs plus IV Lido in patients undergoing erector spinae plane (ESP) and quadratus lumborum (QL) blocks for video assisted thoracic surgery (VATS) and abdominal/retroperitoneal surgeries, respectively. Patients and Method: Using our IRB approved registry (PRO10120146), we retrospectively reviewed the electronic record of 105 patients, including 51 patients who underwent VATS and received either single injection erector plane block (SESPB) plus IV lido or continuous erector spinae plane block (CESPB), and 54 patients who underwent major abdominal surgery and received either single injection quadratus lumborum block (SQLB) plus IV Lido or continuous quadratus lumborum block (CQLB). Demographics, verbal pain scores (0-10), and opioid consumption (morphine intravenous equivalent; MIVE), all in the context of the same multimodal approach (acetaminophen, ketamine, dexmedetomidine, and ketorolac) were collected at 24, 48, and 72 hours after surgery. Alpha was set to 0.05. Results: SNBs plus IV Lido were as effective as CNBs in regard to pain control and total MIVE at 24, 48, or 72 hours after surgery. Subgroup analysis indicated similar findings were observed in patients who underwent VATS or major abdominal surgery. Conclusions: This analysis suggests that SNBs plus IV Lido are as effective as CNBs for perioperative pain management when ESP or QL blocks are used for VATS or major abdominal surgery, respectively. Keywords: Regional anesthesia, quadratus lumborum block, erector spinae plane block, acute pain

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Section: Introductionmentioning

confidence: 99%

“…In the past few years, the use of interfacial plane blocks has been more and more advocated, 20 including erector spinae plane blocks (ESPB) for thoracic surgery, 21-25 pectoralis and serratus blocks for breast surgery 26-29 and quadratus lumborum (QL) blocks for abdominal surgery, 30…”

Section: Introductionmentioning

confidence: 99%

Single Injection Nerve Blocks Plus IV Lidocaine Infusions as an Alternative to Continuous Nerve Blocks for Perioperative Pain Management: A retrospective review

Громов

Kearns

Chelly

2022

Preprint

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“…When TEA is contraindicated, such as patient refusal, coagulation abnormalities, elevated intracranial pressure, and infection over the Tuohy needle insertion site, IV-PCA appears to be a reasonable alternative for pain control [ 25 ]. Nonetheless, opioid is often associated with adverse drug events (ADEs), including nausea, vomiting, delayed return of urinary and bowel function, over-sedation, respiratory depression, and exacerbation of hepatic encephalopathy [ 26 , 27 ], which becomes significant postoperatively when opioid metabolism may be impaired in correlation with the size of liver resection [ 28 ]. Optimal pain control without severe ADEs, therefore, is of utmost importance.…”

Section: Introductionmentioning

confidence: 99%

“…These blocks appear promising as analgesia is achieved while reducing opioid requirements. Patients may be able to have improved respiratory function leading to a shorter length of hospital stay and better satisfaction of the patients [ 26 , 27 , 29 , 30 , 31 , 32 , 33 ]. Generally, an open hepatectomy incision requires dermatome coverage from approximately T6 to T10, which can be covered by bilateral TAP blocks or left-sided rectus sheath block in addition to a right-sided TAP block [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Comparison of Three Patient-Controlled Analgesic Strategies: Intravenous Opioid Analgesia Plus Abdominal Wall Nerve Blocks versus Epidural Analgesia versus Intravenous Opioid Analgesia Alone in Open Liver Surgery

Tsai

Zheng

et al. 2022

Biomedicines

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Background: Adequate pain control is of crucial importance to patient recovery and satisfaction following abdominal surgeries. The optimal analgesia regimen remains controversial in liver resections. Methods: Three groups of patients undergoing open hepatectomies were retrospectively analyzed, reviewing intravenous patient-controlled analgesia (IV-PCA) versus IV-PCA in addition to bilateral rectus sheath and subcostal transversus abdominis plane nerve blocks (IV-PCA + NBs) versus patient-controlled thoracic epidural analgesia (TEA). Patient-reported pain scores and clinical data were extracted and correlated with the method of analgesia. Outcomes included total morphine consumption and numerical rating scale (NRS) at rest and on movement over the first three postoperative days, time to remove the nasogastric tube and urinary catheter, time to commence on fluid and soft diet, and length of hospital stay. Results: The TEA group required less morphine over the first three postoperative days than IV-PCA and IV-PCA + NBs groups (9.21 ± 4.91 mg, 83.53 ± 49.51 mg, and 64.17 ± 31.96 mg, respectively, p < 0.001). Even though no statistical difference was demonstrated in NRS scores on the first three postoperative days at rest and on movement, the IV-PCA group showed delayed removal of urinary catheter (removal on postoperative day 4.93 ± 5.08, 3.87 ± 1.31, and 3.70 ± 1.30, respectively) and prolonged length of hospital stay (discharged on postoperative day 12.71 ± 7.26, 11.79 ± 5.71, and 10.02 ± 4.52, respectively) as compared to IV-PCA + NBs and TEA groups. Conclusions: For postoperative pain management, it is expected that the TEA group required the least amount of opioid; however, IV-PCA + NBs and TEA demonstrated comparable postoperative outcomes, namely, the time to remove nasogastric tube/urinary catheter, to start the diet, and the length of hospital stay. IV-PCA with NBs could thus be a reliable analgesic modality for patients undergoing open liver resections.

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“…The transversus abdominis plane block (TAP block) which was described by Rafi et al in 2001, is a regional anesthesia technique that requires administration of local anesthetic solution below the fascia between the transversus abdominis muscle and internal oblique muscle of the anterior abdominal wall. [1][2][3][4] The benefits of TAP block are analgesia without sympathetic blockade and the consequent hypotension or bradycardia, unlike in neuraxial block; also, opioid-induced pruritus, nausea, and vomiting are generally not observed with TAP block. [5][6][7] The technical difficulty with ultrasoundguided TAP block and a dearth of time, discourage to perform the block; therefore, we designed this study to ascertain the efficacy of double pop blind TAP block, which can be delivered even in a resource-poor hospital set up.…”

Section: Introductionmentioning

confidence: 99%

Eﬃcacy of Double Pop Blind TAP Block – Double-Blinded Randomized Controlled Study

Richard

Goel

Mishra

et al. 2020

AJMR

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Background: The transversus abdominis plane block (TAP block) in the petit triangle is being used since 2001 for analgesia by blocking the T6 to T12 nerves, which is devoid of the sympathetic blockade and has opioid-sparing effect during and after abdominal operations. The appropriateness and efficacy of using double pop blind transversus abdominis plane block were studied in abdominal surgeries using bupivacaine with butorphanol as additive. Subjects and Methods: A total of 78 adult patients of ASA I and II were included, who were to undergo laparoscopic cholecystectomy under general anesthesia. The control group patients received tramadol, diclofenac, and paracetamol in the perioperative period. The study group patients received TAP block by double pop blind technique after induction of anesthesia but before surgical incision as preemptive analgesia. The p-value, the mean and the confidence interval were calculated by using Student t-test with the use of online software by graphpad.com. Results: Each of the two groups had 39 patients, and none met the exclusion criteria. Patients of the study (TAP) group remained pain-free for a longer time by 439 (416 – 463) minutes more than the control (IV, Intravenous) group. Rescue analgesia in the study group was required 640 minutes after the end of the surgery, but in the control group, rescue analgesia was required earlier at 200 minutes only after the surgery. Conclusion: Double pop blind technique for TAP block is appropriate and without complications if done with carefulness as to avoid penetration of the blunted green needle beyond the fascia between the internal oblique and the transversus abdominis muscle.

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<p>Anesthetic techniques: focus on transversus abdominis plane (TAP) blocks</p>

Cited by 20 publications

References 31 publications

Single Injection Nerve Blocks Plus IV Lidocaine Infusions as an Alternative to Continuous Nerve Blocks for Perioperative Pain Management: A retrospective review

Single Injection Nerve Blocks Plus IV Lidocaine Infusions as an Alternative to Continuous Nerve Blocks for Perioperative Pain Management: A retrospective review

A Retrospective Comparison of Three Patient-Controlled Analgesic Strategies: Intravenous Opioid Analgesia Plus Abdominal Wall Nerve Blocks versus Epidural Analgesia versus Intravenous Opioid Analgesia Alone in Open Liver Surgery

Eﬃcacy of Double Pop Blind TAP Block – Double-Blinded Randomized Controlled Study

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