Randomized Clinical Trial of Transversus Abdominis Plane Block Versus Placebo Control in Live-Donor Nephrectomy

Hosgood, Sarah A.; Thiyagarajan, Umasanker M.; Nicholson, Harriet F. L.; Jeyapalan, I.; Nicholson, Michael L.

doi:10.1097/tp.0b013e31825c1697

Cited by 73 publications

(97 citation statements)

References 22 publications

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“…19,23,25,40,64,65 Transversus abdominal plane block did not reduce sixhour, 19,23,25 12-hr, 19,25,40 or 24-hr pain scores 19,23,25,40,65 ( Table 2). In comparison with placebo, the effect of the TAP block on morphine consumption at 24 hr 19,23,25,40 was also not significant (-14.2 mg; 95% CI, -30.6 to 2.2; P = 0.09)…”

Section: Transversus Abdominal Plane Block In Urologic Surgerymentioning

confidence: 99%

Le bloc dans le plan du muscle transverse de l’abdomen pour réaliser une analgésie postopératoire: revue systématique et méta-analyse des études randomisées contrôlées

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

123

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Purpose The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. Source We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i.e., placebo, epidural analgesia, intrathecal morphine (ITM), and ilioinguinal nerve block after abdominal surgery]. Meta-analyses were performed on postoperative pain scores at rest at six, 12, and 24 hr (visual analogue scale, 0-10) and on 24-hr opioid consumption. Principal findings In the 51 trials identified, compared with placebo, TAP block reduced the VAS for pain at six hours by 1.4 (95% confidence interval [CI], -1.9 to -0.8; P\0.001), at 12 hr by 2.0 (95% CI, -2.7 to -1.4; P\0.001), and at 24 hr by 1.2 (95% CI, -1.6 to -0.8; P \ 0.001). Similarly, compared with placebo, TAP block reduced morphine consumption at 24 hr after surgery (mean difference, -14.7 mg; 95% CI, -18.4 to -11.0; P \0.001). We observed this reduction in pain scores and morphine consumption in the TAP block group after gynecological surgery, appendectomy, inguinal surgery, bariatric surgery, and urological surgery. Nevertheless, separate analysis of the studies comparing ITM with TAP block revealed that ITM seemed to have a greater analgesic efficacy. Conclusions The TAP block can play an important role in the management of pain after abdominal surgery by reducing both pain scores and 24-hr morphine consumption. It may have particular utility when neuraxial techniques or opioids are contraindicated. RésuméObjectif Le bloc dans le plan du muscle transverse de l'abdomen (ou TAP bloc) a été décrit comme une technique efficace de contrô le de la douleur après une chirurgie abdominale. Nous avons réalisé une revue systématique et une méta-analyse des études randomisées contrô lées (ERC) pour faire un état des lieux du nombre croissant d'études

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Section: Transversus Abdominal Plane Block In Urologic Surgerymentioning

confidence: 99%

Le bloc dans le plan du muscle transverse de l’abdomen pour réaliser une analgésie postopératoire: revue systématique et méta-analyse des études randomisées contrôlées

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

123

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“…A study in laparoscopic colorectal surgery concluded that TAP block could indeed control postoperative pain and reduce consumption of analgesics drugs [18]. Hosgood et al [19] reported efficacy of TAP blocks in a placebo-controlled trial. A study by Dudderidge et al [10] evaluating modified care pathways for prostatectomy also included (although not directly evaluated) TAP blocks (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Pain Control after Laparoscopic Radical Prostatectomy: Comparison between Unilateral Transversus Abdominis Plane Block and Wound Infiltration

et al. 2019

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Background and Objectives: To determine the efficacy of unilateral transversus abdominis plane (TAP) block versus wound local infiltration for postoperative pain following laparoscopic radical prostatectomy (LRP). Methods: Data of consecutive patients who underwent extraperitoneal LRP and received either wound infiltration or unilateral TAP block for analgesia were retrospectively analyzed. The patients were divided into 2 groups based on the technique used. We compared pain intensity scores and on-demand analgesic use both during the hospital stay and post-discharge between the 2 groups. Results: A total of 48 patients were included, 27 received unilateral TAP blocks (group 1) and 21 were managed with wound infiltration (group 2). The unilateral TAP block group showed lower median pain scores on postoperative days (POD) 1 with pain scores being 0.2 (0–4) and 0.8 (0–4), respectively (p < 0.05). On POD2, the median pain intensity was 0.9 (0–5) and 1.6 (0–6) in groups 1 and 2, respectively (p < 0.05). The median number of on-demand analgesic doses during the POD1 was 0.2 (0–2) and 0.4 (0–2) in groups 1 and 2, respectively (p = 0.19). On POD2, the patients received 0.5 (0–2) and 1.1 (0–3) on-demand doses in groups 1 and 2, respectively (p < 0.05). Conclusion: Unilateral TAP block might improve pain control more pronounced after LRP than wound infiltration.

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“…44,46 O bloqueio foi feito no pré-operatório em 15 18,21,[28][29][30][31][32]34,35,37,38,40,43,44 e no pós-operatório em 16. 17,19,20,22-27,34,37,40-43,47 Obtiveram-se resultados favoráveis em 11 de 15 feitos no pré-operatório 18,21,[29][30][31]33,35,36,38,39,42 e 11 de 16 no pós-operatório. 19,[24][25][26][27][40][41][42][43]47 No entanto, não houve ECR que comparassem TAP pré-operatório vs.…”

Section: Abordagem E Tempo Para Realização Do Bloqueiounclassified

“…Várias AL e concentrações foram usadas em TAP: bupivacaína em 10 (0,25% em quatro 21,30,35,39 ; 0,375% em dois 17,43 ; 5% em quatro 26,29,30 e 1 mg.kg ---1 em um 33 ); levobupivacaína em cinco (0,25% em um 24 ; 0,375% em um; 22 0,5% em dois 28,38 e 2 mg.kg ---1 em um; 18 ) e ropivacaína em 15 (0,25% em dois, 36,45 0,375% em seis 20,25,[42][43][44][45][46] ; 0,5% em cinco; 20,36,37,[39][40][41] 0,75% em um; 28 e 1 mg.kg ---1 em um 23 ). Adicionou-se adrenalina em três 22,37,45 e clonidina em um.…”

Section: Drogas Volumes E Dosesunclassified

“…58 O TAP medioaxilar unilateral mostrou fornecer analgesia adequada em doentes submetidos à apendicectomia por via aberta. 40 Recentemente Hosgood et al 42 e Parikh et al 43 demonstraram a eficácia da TAP medioaxilar nefrectomia do doador. Wu et al, 46 concluem que peridural é superior à dose única via TAP oblíqua subcostal para gastrectomia radical, embora provavelmente o uso de cateteres para TAP possam melhorar estes resultados, como sugerido por Niraj et al 17 e estudos em cirurgias renal e hepatobiliar não encontrando diferenças entre TAP com cateter e anestesia peridural.…”

Section: Nível Sensitivo Duração Do Bloqueio E Complicaçõesunclassified

See 1 more Smart Citation

Eficácia analgésica do bloqueio ecoguiado do plano transverso do abdome – revisão sistemática

Ripollés

Mezquita

Abad

et al. 2015

Brazilian Journal of Anesthesiology

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The TAP have been shown to be an effective technique in colorectal surgery, cesarean section, cholecystectomy, hysterectomy, appendectomy, donor nephrectomy, retropubic prostatectomy, and bariatric surgery. However, the data found in RCT are not conclusive, and as a result, it is necessary to develop new and well designed RCT, with enough statistical power to compare different approaches, drugs, doses, and volumes for the same intervention, aiming to answer the current questions and their effects in the habitual clinical practice.

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Randomized Clinical Trial of Transversus Abdominis Plane Block Versus Placebo Control in Live-Donor Nephrectomy

Abstract: The TAP block procedure is beneficial in reducing postoperative pain and early morphine requirements in laparoscopic live-donor nephrectomy.

Cited by 73 publications

References 22 publications

Le bloc dans le plan du muscle transverse de l’abdomen pour réaliser une analgésie postopératoire: revue systématique et méta-analyse des études randomisées contrôlées

Le bloc dans le plan du muscle transverse de l’abdomen pour réaliser une analgésie postopératoire: revue systématique et méta-analyse des études randomisées contrôlées

Pain Control after Laparoscopic Radical Prostatectomy: Comparison between Unilateral Transversus Abdominis Plane Block and Wound Infiltration

Eficácia analgésica do bloqueio ecoguiado do plano transverso do abdome – revisão sistemática

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