Ultrasound-guided bilateral subcostal TAP block for epigastric hernia repair: A case series

Bhatia, Pradeep; Bihani, Pooja; Chhabra, Swati; Sharma, Vandana; Jaju, Rishabh

doi:10.4103/ija.ija_594_18

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…If either this block fails, opioids supplementation or change of anaesthetic care plan to GA may be warranted. Block success rate in our study was 100% and this result was comparable with Bhatia et al [20] and Elsabenny et al [5]. The percentage of patients who required postoperative rescue Tramadol was 20% (3/15) in our study and all the pain subsided with one dose of Tramadol 100 mg. Elsabenny et al [5] reported a postoperative rescue morphine requirement of 4.8% (1/21) and 100% (22/22) with continuous segmental thoracic EA and GA, respectively.…”

Section: Resultssupporting

confidence: 90%

“…Chansoria et al [12] reported 64.5% (20/31) of increased defecation. Patient satisfaction scores and surgeon satisfaction score of our study were comparable with Elsabenny et al [5] and Bhatia et al [20], respectively. The major limitation of the study was that it is a feasibility study with limited study population.…”

Section: Resultssupporting

confidence: 89%

“…Bharathi et al [19] facilitated anaesthesia for feeding jejunostomy with bilateral SC TAP block and dexmeditomedine sedation without any opioids. Bhatia et al [20] performed ultrasound guided bilateral TAP block for 8 patients scheduled for open epigastric hernia repair and required rescue fentanyl of 25 micrograms twice for two patients.…”

Section: Resultsmentioning

confidence: 99%

“…The percentage of patients who required postoperative rescue Tramadol was 20% (3/15) in our study and all the pain subsided with one dose of Tramadol 100 mg. Elsabenny et al [5] reported a postoperative rescue morphine requirement of 4.8% (1/21) and 100% (22/22) with continuous segmental thoracic EA and GA, respectively. Bhatia et al [20] reported that 25% (2/8) of patients required two doses of paracetamol in the postoperative period and rest of the patients were pain free in the postoperative period. Kadam et al [21] performed USG guided continuous TAP block with catheter and administration of CP block by surgeon in patients who underwent open gastric bypass and whipple's procedure with general anaesthesia at the end of the surgery before abdominal closure.…”

Section: Resultsmentioning

confidence: 99%

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Untitled

2023

J. Med. Chem. Sci.

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Background: General or Regional anaesthesia are the most common anaesthetic techniques practiced for open palliative feeding jejunostomy (PFJ) for advanced esophageal cancer. However, it is not devoid of technique specific complications accounting to perioperative morbidity and mortality. In this study, a combination of ultrasound guided bilateral Subcostal Transverse abdominis plane (SC TAP) block and a novel supraceliac approach to ultrasound guided Celiac Plexus (CP) block was evaluated for its safety and efficacy in providing surgical anaesthesia for open PFJ. Methods: This prospective feasibility study was conducted in 15 patients scheduled for open PFJ. We performed bilateral ultrasound guided SC TAP block and ultrasound guided CP block using a novel supraceliac approach to attain surgical anaesthesia for open PFJ. The variables such as percentage of patients requiring intraoperative and postoperative rescue analgesics and pain scores, block success rate, block performance time, duration of postoperative analgesia and side effects were recorded. Results: Percentage of patients who required rescue analgesics in the intraoperative period and postoperative period were 6.6% and 20% respectively, with a block success rate of 100%. Intraoperative pain scores measured by verbal rating scale was 1 in all the patients except one patient who had a score of 2. Median postoperative pain scores measured by visual analog scale were 0 for first 12 postoperative hours. The side effects were minimal and manageable. Conclusion:The combination of bilateral ultrasound guided SC TAP block and the novel ultrasound guided supraceliac approach to CP block was a feasible, efficacious, and safe technique to provide surgical anaesthesia for open PFJ in patients with advanced esophageal malignancy.

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Section: Resultssupporting

confidence: 90%

Section: Resultssupporting

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Untitled

2023

J. Med. Chem. Sci.

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“…Similar results were discussed by Sinha et al [7], Jain et al [8], Bhatia et al [9], and Paash et al [10]. In contrast to Karamanos et al [11], we found that epidural analgesia resulted in a statistically significant decrease in postoperative pain levels on POD 0 instead of 1, but only in the IPOM group.…”

Section: Discussionsupporting

confidence: 91%

TAP Block Prior to Open Ventral Hernia Repair Improves Surgical Outcome

2022

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Background Ventral hernias commonly affect patients after major abdominal surgery. To reduce postoperative pain, the effects of the transversus abdominis plane (TAP) block, epidural analgesia and medication-only protocol have been investigated. The primary outcome was the cumulative dosage of opioids (morphine milligram equivalents MME), of acetaminophen and diclofenac for postoperative pain control on postoperative day (POD) 0, 1, and 2. Secondary outcomes were length of stay (LOS) and the pain scale rating using the numeric rating scale (NRS) on POD 0, 1, and 2. Methods The data were retrospectively extracted from the charts of the patients admitted for a surgical operation for OVHR from January 2015 to December 2019. Results Patients receiving medication-only analgesia had longer LOS (mean 6.1 days; p < 0.00001). Cumulative opioid consumption was significantly lower at 24 and 48 h after surgery in the TAP block group than in the other groups (mean MME 1.9 mg and 0.7 mg, respectively; p < 0.05). The cumulative consumption of diclofenac was significantly lower in the TAP block group than in the others (44.1 mg; p ≤ 0.00001 on POD 1; 4.4 mg; p = 0.03 on POD 2). TAP block is more effective in pain control in POD 0 (mean NRS 5.4; p < 0.00001), POD 1 (mean NRS 6.1; p = 0.006), and POD 2 (mean NRS 4.9; p = 0.001) if it is performed after adopting the retromuscular technique. Conclusions The comparison between the medication-only technique, epidural, and TAP block demonstrated the superiority of the last one for the aims considered in this study.

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