Post-operative pain after ultrasound transversus abdominis plane block versus trocar site infiltration in laparoscopic nephrectomy: a prospective study

Araújo, Ana Cristina; Guimarães, Joana; Nunes, Catarina S.; Couto, Paula Sá; Amadeu, E.

doi:10.1016/j.bjane.2016.08.004

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…In a comparison of the effects of TAP block to wound infiltration, Araújo, A. M. et al [15] demonstrated that the intraoperative remifentanil consumption, morphine administration in the recovery room, and postsurgical pain scores as well as the functional recovery variables were all comparable in laparoscopic nephrectomy. In addition, Azawi, N. H. et al [16] found that the pain score and sufentanil and morphine consumption in the first postoperative hour were even higher in the TAP block group for nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: A randomized controlled study

Lin²

2019

Preprint

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Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether it is useful in renal surgery involving access through the lateral abdominal wall remains unknown. Therefore, the study was aimed at evaluating the analgesic efficacy of lateral TAP block for retroperitoneoscopic partial or radical nephrectomy. Method In this prospective, randomized, double-blind, placebo-controlled trial, eligible patients were randomized into the intervention (T) and control (C) groups. After anesthesia induction, ultrasound-guided lateral TAP block was performed preoperatively with 30 mL of 0.4% ropivacaine and an equivalent amount of normal saline in groups T and C, respectively. The primary outcomes were opioid consumption during surgery and in the first 24 h after surgery. Secondary outcomes were postsurgical pain intensity at immediately awakening from anesthesia, and 0.5, 1, 2, 6, 12, 24 h after surgery, and recovery quality variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage in the first 24 h after surgery, and length of hospital stay. Results 104 patients were enrolled and randomized: 53 and 51 in groups T and C, respectively. The median intraoperative sufentanil and remifentanil and postoperative sufentanil consumption per kilogram in the first 24 h after surgery was 0.33, 9.02, and 0.57 μg in Group T, respectively; the corresponding values in Group C were 0.30, 9.58, and 0.48 μg, all of which were not significant (p = 0.528, 0.903, and 0.244). Postsurgical pain intensity at all time points was comparable between the groups (all p > 0.05). Intergroup differences in recovery quality variables were not significant (all p > 0.05). Conclusion Our findings demonstrated that preoperative lateral TAP could not decrease intraoperative and postoperative opioid consumption and pain intensity in the first 24 h after surgery, nor could it promote postoperative recovery in patients undergoing laparoscopic renal surgery through retroperitoneal access.

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Section: Discussionmentioning

confidence: 99%

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: A randomized controlled study

Lin²

2019

Preprint

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“…A TAP block has been shown to provide effective analgesia after a variety of abdominal surgeries, 3‐6 including LLDN 7,8 . Single‐injection TAP blocks for LLDN were equally effective as thoracic epidural infusions or local infiltration of anesthetic agents 9 …”

Section: Introductionmentioning

confidence: 99%

“…7,8 Single-injection TAP blocks for LLDN were equally effective as thoracic epidural infusions or local infiltration of anesthetic agents. 9 Single-injection TAP blocks with ropivacaine or bupivacaine only provide ~8-12 hours of sensory blockade 10 ; therefore, continuous infusion of local anesthetics by TAP catheter has also been used. 11,12 Continuous TAP blocks would theoretically provide longer-lasting analgesia, and although published evidence for this is lacking, TAP catheters have been requested by surgeons at our institution.…”

Section: Introductionmentioning

confidence: 99%

Transversus abdominis plane (TAP) block for laparoscopic live donor nephrectomy: Continuous catheter infusion provides no additional analgesic benefit over single‐injection ropivacaine

et al. 2020

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Background Transversus abdominis plane (TAP) blocks are useful for adjunctive pain control following laparoscopic live donor nephrectomy (LLDN). The objective was to determine if TAP catheter provides additional analgesia compared with single‐injection TAP block alone for kidney donors. Methods In this prospective, double‐blinded, randomized controlled trial, LLDN patients received a single TAP injection of 30 mL 0.2% ropivacaine and had a catheter inserted into the TAP space. Postoperatively, either 0.2% ropivacaine (TAP catheter group; TAP‐C) or saline (TAP saline group; TAP‐S) was infused at 10 mL/h. Pain scores, narcotic usage, nausea, and sedation were evaluated at 1, 12, 24, 36, 48, and 60 hours. Results The study population included 70 patients (35 randomly assigned to each group). No differences in pain scores, narcotic usage, nausea, or sedation were observed at any time point (with the exception of lower median pain score for TAP‐S at 60 hours; 3.2 vs 3.9 for TAP‐C; P = .03). Conclusions The lower pain score for placebo group at 60‐hour postoperative is likely clinically insignificant. The TAP catheter infusion provided no benefit over a single‐injection TAP block; thus, the added risk and cost are not supported. Liposomal bupivacaine should be evaluated in future studies.

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Post-operative pain after ultrasound transversus abdominis plane block versus trocar site infiltration in laparoscopic nephrectomy: a prospective study

Cited by 5 publications

References 10 publications

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: A randomized controlled study

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: A randomized controlled study

Transversus abdominis plane (TAP) block for laparoscopic live donor nephrectomy: Continuous catheter infusion provides no additional analgesic benefit over single‐injection ropivacaine

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