Sensory Assessment and Regression Rate of Bilateral Oblique Subcostal Transversus Abdominis Plane Block in Volunteers

Chen, Yue; Shi, Kenrin; Xia, Yun; Zhang, Xuezheng; Papadimos, Thomas J.; Xu, Xuzhong; Wang, Quanguang

doi:10.1097/aap.0000000000000715

Cited by 40 publications

(44 citation statements)

References 17 publications

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“…We defined a successful active sensory block as a lost or markedly reduced perception of cold. 12 Thirty minutes after ropivacaine injection, anesthesiologist who did the SAP block confirmed the loss of the dermatomal sensory. All patients underwent general anesthesia performed by attending anesthesiologists who were not involved in the study and blinded to grouping.…”

Section: Methodsmentioning

confidence: 94%

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<p>Effects of Ropivacaine Concentration on Analgesia After Ultrasound-Guided Serratus Anterior Plane Block: A Randomized Double-Blind Trial</p>

Huang¹,

Zheng²,

Wu³

et al. 2020

JPR

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Serratus anterior plane (SAP) block is effective for analgesia after breast surgery. Whether a higher local anesthetic concentration prolongs sensory block duration and improves postoperative analgesia remains unclear. The aim of this study was to compare the analgesic effects of SAP block with different concentrations of ropivacaine. Patients and Methods: Sixty patients scheduled for breast surgery were enrolled in this randomized double-blind trial. SAP block was induced with 20 mL of 0.375%, 0.5%, or 0.75% ropivacaine in Group R0.375, Group R0.5, and Group R0.75, respectively. The primary endpoint was the area under the curve (AUC) of numerical rating scale (NRS) pain intensity scores at rest over time. The secondary endpoints were AUC of NRS pain intensity scores on movement over time, active sensory block duration, tramadol consumption, and the elapsed time between completion of surgery and the first administration of rescue analgesia. Results: The AUC of NRS pain intensity scores at rest of Group R0.375 was significantly higher than that of Groups R0.5 and R0.75 (P=0.025, and P=0.001). The AUC of NRS pain intensity scores on movement of Group R0.375 was also significantly higher than that of Groups R0.5 and R0.75 (both P<0.001). At higher ropivacaine concentrations, the duration of SAP sensory block increased (P<0.001). Tramadol consumption and the elapsed time between completion of surgery and the first administration of rescue analgesia were similar in the three groups (P>0.05). Conclusion: A comparison of 0.5% and 0.75% ropivacaine showed no significant difference in postoperative analgesia, but both were superior to 0.375% ropivacaine, although higher ropivacaine concentration lengthened the duration of SAP block. Therefore, SAP block with 0.5% ropivacaine is recommended for postoperative analgesia in breast surgery.

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Section: Methodsmentioning

confidence: 94%

“…Børglum et al reported that both testing methods yielded similar results when assessing the efficacy of transverse abdominis plane blocks. 22 Previous studies used cold stimuli to assess sensory block duration after regional anesthesia with the aim of reducing patient discomfort, 12,23 so we employed the same approach.…”

Section: Figurementioning

confidence: 99%

<p>Effects of Ropivacaine Concentration on Analgesia After Ultrasound-Guided Serratus Anterior Plane Block: A Randomized Double-Blind Trial</p>

Huang¹,

Zheng²,

Wu³

et al. 2020

JPR

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“…12,18,19 In a study assessing sensory loss in healthy volunteers, bilateral oblique subcostal TAP block with 20 mL of 0.375% ropivacaine effectively blocked T7-T12 dermatomes of the midabdomen. 33 In the light of this information we assumed that a volume of 30 mL should be enough for achieving adequate spread of local anesthetic mixture.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Analgesic Effects of Preemptive Ultrasound-Guided Subcostal Transversus Abdominis Plane Block for Percutaneous Nephrolithotomy: A Prospective, Randomized Trial

Özdilek

Beyoglu

Demirdağ

et al. 2020

Journal of Endourology

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Background and Objectives: Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure for removing kidney stones, but patients still suffer from moderate postoperative pain. The aim of this study is to evaluate the perioperative analgesic effect of ultrasound-guided subcostal transversus abdominis plane (TAP) block performed before PCNL procedure. Materials and Methods: Patients scheduled for elective PCNL were randomized into two groups: Group TAP and Group IV. General anesthesia was induced with propofol, fentanyl, and rocuronium and maintained with sevoflurane, fentanyl, and rocuronium. Unilateral ultrasound-guided TAP block was performed with total of 30 mL volume of local anesthetic solution (20 mL bupivacaine 0.125% plus 10 mL lidocaine 1%) after intubation but before surgery to the Group TAP patients. Paracetamol 1 g was given to the Group IV. Tramadol 100 mg and morphine IV-patient-controlled analgesia were applied to both groups. Perioperative fentanyl consumption, postoperative verbal analog scale (VAS), morphine consumption, and additional analgesic drug requirement were assessed. Chi square with Yates correction and Mann-Whitney U tests were used for statistical analysis. Results: Eighty patients were assessed for enrollment. One patient developed septicemia at the recovery room so data of 79 patients were collected for statistical analysis. Total morphine consumption at 48th hour after the surgery was lower at Group TAP (p = 0.022). Perioperative fentanyl consumption was lower at Group TAP (p < 0.001). Additional analgesic requirement and VAS were comparable between groups. Conclusions: Preemptive unilateral ultrasound-guided subcostal TAP block decreases perioperative fentanyl and postoperative total morphine consumption in PCNL patients compared to IV analgesic management.

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“…RISS block offers an advantage over transverse abdominus plane (TAP) block as the second does provide consistent coverage to lower thoracic dermatome areas. Even the subcostal TAP does not cover the lateral supraumbilical area [15]. Moreover, the clinical advantage of RISS block is that the point of injection is distant from most surgical incisions, and a catheter is unlikely to interfere with the surgical field [3].…”

Section: Discussionmentioning

confidence: 99%

Rhomboid intercostal and subserratus plane block -a case series-

Elsharkawy

Hamadnalla

Altınpulluk

et al. 2020

Korean J Anesthesiol

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Background: The Rhomboid intercostal and Subserratus plane (RISS) block is a new interfascial block that has shown promising results for abdominal and thoracic surgeries. Our objective was to describe improved analgesia and dermatomal coverage within the patients who received bilateral ARISS blocks after major abdominal surgery. Case: Twenty-one patients who underwent abdominal surgery received the rhomboid intercostal component of the block at the level of T5 to T6 and the subserratus component block was performed at T6 to T9 level (either single injections or catheter infusion). RISS blocks provided effective postoperative analgesia. There was a variation of dermatomal coverage ranging from T3 to T12. Patients reported a high satisfaction rate from pain management. Conclusions: RISS block in abdominal surgery seems to have an important role in perioperative pain management complementing the multimodal analgesic regimen. To determine the efficacy of RISS block for abdominal surgery, further randomized control trials are needed.

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Sensory Assessment and Regression Rate of Bilateral Oblique Subcostal Transversus Abdominis Plane Block in Volunteers

Abstract: Bilateral oblique subcostal TAP block produces a widespread cutaneous sensory blockade with a consistent dermatomal distribution in the midabdomen for a considerable effective duration.

Cited by 40 publications

References 17 publications

<p>Effects of Ropivacaine Concentration on Analgesia After Ultrasound-Guided Serratus Anterior Plane Block: A Randomized Double-Blind Trial</p>

<p>Effects of Ropivacaine Concentration on Analgesia After Ultrasound-Guided Serratus Anterior Plane Block: A Randomized Double-Blind Trial</p>

Perioperative Analgesic Effects of Preemptive Ultrasound-Guided Subcostal Transversus Abdominis Plane Block for Percutaneous Nephrolithotomy: A Prospective, Randomized Trial

Rhomboid intercostal and subserratus plane block -a case series-

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