Ultrasound-guided transversus abdominis plane blocks for patients undergoing laparoscopic hand-assisted nephrectomy: a randomized, placebo-controlled trial

Aniskevich, Stephen; Taner, C. Burcin; Perry, Dana K.; Robards, Christopher B.; Porter, Steven B.; Thomas, Colleen S.; Logvinov, Ilana I.; Clendenen, Steven R.

doi:10.2147/lra.s61589

Cited by 37 publications

(35 citation statements)

References 20 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: 94%

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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

124

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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: 94%

“…Pain scores at six and 12 hr were investigated in 23 and 18 [16][17][18][19][20][21][22][23]25,26,29,31,32,[34][35][36][38][39][40][41] studies, respectively. The overall analyses showed that, in the TAP block group, the six-hour VAS pain score was reduced by 1.4 (95% CI, -1.9 to -0.8; P \ 0.001) (Fig.…”

Section: Transversus Abdominal Plane Block Vs Placebomentioning

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

124

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“…The third study was unable to demonstrate any analgesic benefits of bilateral preincisional TAP blocks; however, it was underpowered (n = 21), and an unspecified number of patients received a supraumbilical rather than infraumbilical retrieval incision, which is unlikely to have been covered by the TAP block. 109 None of the 3 studies utilized perioperative multimodal analgesia. Based on this limited evidence, TAP blocks may contribute to analgesia in the early postoperative period following laparoscopic donor nephrectomy, but the magnitude of benefit when added to a multimodal analgesic regimen is unclear.…”

Section: Laparoscopic Donor Nephrectomymentioning

confidence: 99%

Essentials of Our Current Understanding

Chin

McDonnell

Carvalho

et al. 2017

Regional Anesthesia and Pain Medicine

332

208

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Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoption of techniques including transversus abdominis plane and rectus sheath blocks, as well as the introduction of novel techniques such as quadratus lumborum and transversalis fascia blocks. These blocks are technically straightforward and relatively safe and reduce pain and opioid requirements in many clinical settings. The data supporting these outcomes, however, can be inconsistent because of heterogeneity of study design. The extent of sensory blockade is also somewhat variable, because it depends on the achieved spread of local anesthetic and the anatomical course of the nerves being targeted. The blocks mainly provide somatic analgesia and are best used as part of a multimodal analgesic regimen. This review summarizes the anatomical, sonographic, and technical aspects of the abdominal wall blocks in current use, examining the current evidence for the efficacy and safety of each.

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“…There are many studies investigating various methods to alleviate pain in patients undergoing urologic surgeries [77]. In previous studies, transversus abdominis plane (TAP) block provided good analgesic effect and reduced opioid consumption in patients undergoing minimally invasive surgery [78,79]. Local anesthetics are delivered into the layer between the internal oblique and transversus abdominis.…”

Section: Pain Control and Recoverymentioning

confidence: 99%

Anesthetic considerations for urologic surgeries

Koo

Ryu

2020

Korean J Anesthesiol

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Urologic surgeries are widely performed, and the cases have increased owing to the fact that the elderly population is growing. The narrow and limited surgical space is a challenge in performing most urologic surgeries. Additionally, the elderly population is exposed to the risk of perioperative complications; therefore, a comprehensive understanding and approach are required to provide optimized anesthesia during surgery. We have searched the literature on anesthesia for urologic surgeries and summarized the anesthetic considerations for urologic surgeries.

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Ultrasound-guided transversus abdominis plane blocks for patients undergoing laparoscopic hand-assisted nephrectomy: a randomized, placebo-controlled trial

Cited by 37 publications

References 20 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

Essentials of Our Current Understanding

Anesthetic considerations for urologic surgeries

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