scholarly journals Transversus Abdominis Plane (TAP) Block: A Comparative Study between Levobupivacaine versus Levobupivacaine plus Ketamine in Abdominoplasty

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Radwa F. Mansour ◽  
Mohamed A. Afifi ◽  
Mohamed S. Abdelghany
Keyword(s):  
Visual Analogue Scale ◽  
Prospective Study ◽  
Analogue Scale ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Prolonged Duration

Purpose. We conducted this study to explore the hypothesis that the addition of ketamine to levobupivacaine in ultrasound-guided Transversus Abdominis Plane (TAP) block would result in a better and prolonged duration of postoperative analgesia for patients undergoing abdominoplasty. Material and Methods. This randomized prospective study was conducted on 50 patients who were scheduled for abdominoplasty. TAP block was performed bilaterally for all patients either with levobupivacaine 0.5% 15 ml plus ketamine 0.5 mg/kg in a total volume of 20 ml in the LK group (n = 25) or with levobupivacaine 0.5% 15 ml plus 5 ml normal saline in a total volume of 20 ml in the L group on each side. Results. Visual analogue scale (VAS) was significantly lower in the LK group in resting condition at 6, 12, and 16 h postoperatively compared to the L group. On movement, the VAS was significantly lower at 4, 6, 8, 12, 16, and 24 h postoperatively in the LK group compared to the L group. The time for first rescue analgesia was longer in the LK group (18.7 ± 4.8 h) than that in the L group (6.5 ± 2.4 h) with the reduced total amount of rescue morphine in the LK group (1.14 ± 2.2 mg) versus the L group (5.86 ± 3.6 mg). Only six patients in the LK group requested rescue morphine, whereas nineteen patients requested rescue morphine in the L group. Conclusions. In TAP block, adding ketamine 0.5 mg/kg enhanced the analgesic efficacy of levobupivacaine 0.5% in patients undergoing abdominoplasty and reduced the required analgesics postoperatively.

A Comparative Study between Ultrasound Guided Bilateral Transversus Abdominis Plane block Versus Opioids (Nalbuphine) Analgesia after Abdominoplasty

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Omar Mohammed Taha Elsafty ◽  
Hanan Mahmoud Farag Awad ◽  
Mostafa Gamal Eldin Mahran ◽  
Haidy Atef Fekry Sadek
Keyword(s):  
Single Injection ◽  
Safety Margin ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
University Hospitals ◽  
Rescue Analgesia ◽  
Prolonged Hospital

Abstract Background Poorly controlled acute pain after abdominoplasty is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and an increased likelihood of chronic pain. Objectives The aim of this study is to assess the analgesic efficacy and hemodynamic effects of bilateral ultrasound guided single injection Transversus Abdominis Plane (TAP) Block compared with intravenous nalbuphine after abdominoplasty. Each of them combined with general anesthesia in patients undergoing abdominoplasty. Patients and Methods The study was conducted on 70 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 35 patients each: Group TAP: bilateral ultrasound guided TAP block was performed before extubation of patients using 20 ml of 0.25% bupivacaine in each side, Group N: received intravenous nalbuphine as post operative analgesia after abdominoplasty. Results The results of the study revealed that single injection tansversus abdominis plane block has more analgesic efficacy than intravenous nalbuphine. The first call for rescue analgesia (nalbuphine), total nalbuphine consumption and pain scores (visual analog score) indicated that the superiority of the analgesic technique (TAP Block) was attributed to their opioid sparing effect. Conclusion An ultrasound-guided TAP block technique allows for direct visualization of all anatomical structures, the needle, and the spread of local anesthetic, thereby increasing the safety margin, optimizing block qualities, decreasing systemic analgesia requirements and sparing its side effects.

EFFICACY OF TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POST CESAREAN DELIVERY ANALGESIA

2018 ◽  
Vol 8 (5) ◽  
pp. 37-41
Author(s):  
Minh Nguyen Van ◽  
Nga Bui Thi Thuy ◽  
Thinh Tran Xuan
Keyword(s):  
Caesarean Section ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Morphine Consumption ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Pain Scores

Background: The transversus abdominis plane block (TAP block), a regional block, provides effective analgesia after lower abdominal surgeries. The objective of this study was to assess whether transversus abdominis plane block is effective as part of multimodal pain management following Cesarean section. Materials and Method: Totally, 60 ASA I and II parturients for Cesarean section via Pfannenstiel incision under spinal anesthesia were randomly allocated to either the TAP block group or the control. The TAP block group received a landmark-orientated, bilateral TAP block with 0.25% levobupivacain 17,5ml each side in the triangle of Petit. Postoperative pain treatment followed the same protocole for both groups with 1gram paracetamol intravenously and received patrient-controlled analgesia with intravenous morphine. The time to first request of analgesic, morphine consumption, visual analogue scale (VAS) pain scores and side effects were scored at 2, 4, 6, 8, 12 h postoperatively. Results: The time to first request of analgesic was longer, morphine consumption was lower in TAP group than in the control (p < 0.05). Visual analogue scale (VAS) pain scores at rest and on mouvement were similar in two groups at 2h, but lower in TAP group from 4h (p < 0.05). No severe adverse effects were detected in two groups. Conclusion: TAP block prolonged the time to fisrt request of analgesic and reduced morphine consumption, the VAS pain scores significantly both at rest and on mouvement. Therefore, TAP block is feasible and effective as part of a multimodal analgesia regimen after Caesarean section. Key words: Caesarean section, multimodal pain management, transversus abdominis plane block

Comparison between Ultrasound Guided Transversus Abdominis Plane Block versus Ultrasound Guided IlioInguinal/Iliohypogastric Nerves Block for Postoperative Analgesia in Patients Undergoing Unilateral Oblique Inguinal Hernia Repair Under General Anesthesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Shrouk Ayman Mohamed Soliman Faramawy ◽  
Samia Abdel-Mohsen Abdel-Latif ◽  
Mohamed Abdel-Salam Menshawe Abdel-Atte ◽  
Ibrahim Mohammed El Sayed Ahmed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
General Anesthesia ◽  
Inguinal Hernia Repair ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Pain Scores

Abstract Background Inguinal hernia considered the third common disease in surgeries for adults after acute appendicitis and proctologic disorders. About 20 millions of inguinal hernia repairs are performed globally. Inguinal herniorrhaphy is frequently associated with persistent postoperative pain. Objectives The aim of this study is to assess the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared to ilioinguinal/iliohypogastric nerves block after unilateral inguinal hernia repair regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received. Patients and Methods The study was conducted on 70 randomly chosen patients aged 21 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia, in Ain Shams University Hospitals after approval of the medical ethical committee. Results The results of the study revealed that there is Patients receiving TAP block had significantly lower pain scores at 4 h and 6 h after operation, delay time for rescue analgesia and decrease total need of analgesic in first 24 h post operative compared with patients who received ilioinguinal/ iliohypogastric nerves block. Conclusion TAP block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to ilioinguinal/iliohypogastric nerves block. This technique can be a promising mode of postoperative analgesia when epidural catheter insertion is contraindicated.

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

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xue Li ◽  
Zhen-Zhen Xu ◽  
Xue-Ying Li ◽  
Ting-Ting Jiang ◽  
Zeng-Mao Lin ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Abdominal Wall ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Controlled Study ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Renal Surgery

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery through the lateral abdominal wall pathway remains unknown. The study aimed to evaluate 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 two groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed with either 30 ml of 0.4% ropivacaine (Group T) or an equivalent volume of normal saline (Group C). The primary outcomes were opioid consumption during surgery and in the first 24 h after surgery. Secondary outcomes included postsurgical pain intensity immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 h after surgery, as well as recovery variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized (53 in Group T and 51 in Group C). Laparoscopic surgery was converted to open surgery in one patient of Group T; this patient was excluded from the outcome analysis. The opioid consumption during surgery (intravenous morphine equivalent dose: median 35.0 mg [interquartile range 18.0, 49.6] in Group C vs. 40.3 mg [20.9, 59.0] in Group T, P = 0.281) and in the first 24 h after surgery (10.8 mg [7.8, 21.7] in Group C vs. 13.2 mg [8.0, 26.6] in Group T, P = 0.311) did not differ significantly between groups. There were no significant differences between groups regarding the pain intensity at all time points after surgery and the recovery variables (all P > 0.05). Conclusions Our results showed that, in patients undergoing retroperitoneoscopic renal surgery, preoperative lateral TAP did not decrease intra- and postoperative opioid consumption, nor did it relieve pain intensity or promote postoperative recovery in the first 24 h after surgery. However, the trial might be underpowered. Trial registration This study was registered on November 4, 2017, in the Chinese Clinical Trail Registry with the identification number ChiCTR-INR-17013244.

scholarly journals A prospective study of efficacy of ultrasound guided transversus abdominis plane block for postcesarean analgesia

2019 ◽  
Vol 8 (5) ◽  
pp. 1951
Author(s):  
Sravani Manam ◽  
R. N. V. Swetha ◽  
A. S. Kameswara Rao ◽  
S. G. K. Murthy
Keyword(s):  
Total Dose ◽  
Postoperative Period ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Group B

Background: The ultrasound guided transversus abdominis plane (TAP) block which provides effective analgesia after lower abdominal surgeries including caesarean section. It is a simple and reliable technique. In this prospective, randomized double-blind study, we determined the efficacy of TAP block using 0.25% Bupivacaine and 0.9N Saline with respect to VAS for pain, postoperative Tramadol consumption and post-operative ondansetron usage.Methods: This study was conducted on 100 adult patients of ASA physical status I and II in the   age group of 18 to 40 years undergoing elective lower segment cesarean section under spinal anaesthesia. Study group received TAP block with 0.25% Bupivacaine and control group received 10 ml of 0.9N saline on each side. Patients were analyzed for postoperative pain by pain score (at rest, on movement, on cough) using VAS was recorded at 0, ½, 1, 2, 4, 6, 12 and 24 hours postoperatively. Need for rescue analgesia was assessed by time to first dose of Tramadol requirement and total dose of Tramadol over 24 hours of postoperative period. Ondansetron (4 mg i.v.) was administered whenever nausea score was more than 2 or the patient vomited. All the data was noted using uniform performs.Results: Patients received TAP block with 0.25% Bupivacaine had better pain scores at first hour of postoperative period during rest, cough and movement which was statistically significant (p<0.0010) in comparison to group B. There was a statistically significant difference (p <0.001) in the requirement of total dose of Tramadol as a rescue analgesia in patients who received transversus abdominis block with 0.25% Bupivacaine (138.77 mg) in comparison with other group(240 mg).The mean time to first request for Tramadol was significantly longer in group A (5.8 hrs)  in comparison to group B (1.93 hrs) with p value <0.001. Patients received TAP block with 0.9N saline needed more dose of Ondansetron, however, the difference was not statistically significant (p >0.001).Conclusions: TAP block using ultrasound provides substantial reduction in Tramadol consumption, time to first dose of rescue tramadol when compared with control group. This study reinforces the recommendation for TAP as a part of multimodal post-operative analgesic regimen.

scholarly journals Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

2021 ◽  
Vol 15 (1) ◽  
pp. 22-29
Author(s):  
Tamer N. Abdelrahman ◽  
Rasha G. Abu-Sinna
Keyword(s):  
Magnesium Sulphate ◽  
Transversus Abdominis ◽  
Anesthetic Technique ◽  
Control Group ◽  
Time Interval ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Group D

Introduction: The TAP block is a regional anesthetic technique, which blocks neural afferents between T6 and L1, which provide anterior abdominal walls and therefore help to alleviate postoperative pain. Aim: The aim is to compare the efficacy of preoperative single low dose of intravenous MgSO4 versus intravenous dexamethasone as adjuvants to ultrasound guided TAP block for prolongation of postcesaren analgesia. Materials and Methods: A total 60 pregnant females were selected undergoing elective caesarean sections under general anesthesia with ultrasound-guided transversus abdominis plane (TAP) block done at the end of surgery. Patients were randomly and equally allocated into three groups of 20 patients each. The first group of patients were classified as magnesium sulphate group (M)who received 50 mg/Kg IV, the second group of patients were classified as dexamethasone group (D) who received 2 mg IV and the third group was classified as the placebo group (C) who received IV saline. Results: Comparison of the VAS at 6 and 12 hours postoperatively showed statistically significantly lower values in group (M) and group (D) compared to group (C) and also group (M) was significantly lower than group (D) as well. The time interval until first rescue analgesia (Nalbuphine) needed by the patients (VAS ≥ 50) was significantly longer in group (M) compared to group (D) and group (C) consecutively. Additionally, it was significantly longer in group (D) than in the control group(C). The total dose of rescue analgesia consumed during the first 24 hours postoperatively was significantly lower in groups (M) than in group (D) and both groups showed lesser doses compared to group (C) Conclusion: We concluded that both MgSO4 and dexamethasone could prolong the postoperative duration and analgesic efficiency provided by the TAP block in cesarean sections. This further reduced the demands for postoperative rescue analgesia, with MgSO4 found to be more efficient than IV dexamethasone. Clinical Trial Registration Number: NCT04223128

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

2019 ◽  
Author(s):  
Xue Li ◽  
Zhen-Zhen Xu ◽  
Xue-Ying Li ◽  
Ting-Ting Jiang ◽  
Zeng-Mao Lin ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Abdominal Wall ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Controlled Study ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Renal Surgery

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery through the lateral abdominal wall pathway remains unknown. The study aimed to evaluate 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 two groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed with either 30 ml of 0.4% ropivacaine (Group T) or an equivalent volume of normal saline (Group C). The primary outcomes were opioid consumption during surgery and in the first 24 hours after surgery. Secondary outcomes included postsurgical pain intensity immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 hours after surgery, as well as recovery variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized (53 in Group T and 51 in Group C). Laparoscopic surgery was converted to open surgery in one patient of Group T; this patient was excluded from the outcome analysis . The opioid consumption during surgery ( intravenous morphine equivalent dose: median 35.0 mg [interquartile range 18.0, 49.6] in Group C vs. 40.3 mg [20.9, 59.0] in Group T, P=0.281) and in the first 24 hours after surgery ( 10.8 mg [7.8, 21.7] in Group C vs. 13.2 mg [8.0, 26.6] in Group T , P=0.311) did not differ significantly between groups. There were no significant differences between groups regarding the pain intensity at all time points after surgery and the recovery variables (all P>0.05). Conclusions Our results showed that, in patients undergoing retroperitoneoscopic renal surgery, preoperative lateral TAP did not decrease intra- and postoperative opioid consumption, nor did it relieve pain intensity or promote postoperative recovery in the first 24 hours after surgery. However, the trial might be underpowered. Trial registration This study was registered on November 4, 2017, in the Chinese Clinical Trail Registry with the identification number ChiCTR-INR-17013244.

scholarly journals A Comparison of effect of preemptive versus postoperative use of ultrasound-guided bilateral transversus abdominis plane (TAP) block on pain relief after laparoscopic cholecystectomy

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Poupak Rahimzadeh ◽  
Seyed Hamid Reza Faiz ◽  
Kaveh Latifi-Naibin ◽  
Mahzad Alimian
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Significant Difference

AbstractNowadays, there are various methods to manage pain after laparoscopic cholecystectomy. The aim of this study was to compare the effectof preemptive versus postoperative use of ultrasound-guided transversus abdominis plane (USG-TAP) block on pain relief after laparoscopic cholecystectomy. In this single-blinded randomized clinical trial, the patients who were candidates for laparoscopic cholecystectomy were randomly divided into the two groups (n = 38 per group). In the preemptive group (PG) after the induction of anesthesia and in the postoperative group (POG) after the end of surgery and before the extubation, bilateral ultrasound-guided transversus abdominis plane (TAP) block was performed on patients using 20 cc of ropivacaine 0.25%. Both groups received patient controlled IV analgesia (PCIA) containing Acetaminophen (20 mg/ml) plus ketorolac (0.6 mg/ml) as a standard postoperative analgesia and meperidine 20 mg q 4 h PRN for rescue analgesia. Using the numerical rating scales (NSR), the patients’ pain intensity was assessed at time of arrival to the PACU and in 2th, 4th, 8th, 12th, 24th h. Primary outcome of interest is NSR at rest and coughing in the PACU and in 2th, 4th, 8th, 12th, 24th h. Secondary outcomes of interests were the time to first post-surgical rescue analgesic and level of patients’ pain control satisfaction in the first 24 h. The USG-TAP block significantly decreased pain score in the POG compared to the PG, and also the pain was relieved at rest especially in 8 and 12 h (p value ≤ 0.05) after the surgery. Pain score after coughing during recovery at 2, 8 and 12 h after the operation were significantly decreased. (p value ≤ 0.05) The patient satisfaction scores in the POG were significantly higher in all times. There was a statistically significant difference between the two groups in terms of rate of postoperative nausea and vomiting (PONV), indicating that patients in the POG had significantly lower incidences of the PONV compared tothe PG. The time to first analgesic request was significantly shorterin the POG, which was statistically significant (p value = 0.089). There was no statistically significant difference between the two groups in terms of consumption of analgesics. The postoperative TAP block could offer better postoperative analgesia than preepmtive TAP block.

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

2019 ◽  
Author(s):  
Xue Li ◽  
Zhen-Zhen Xu ◽  
Xue-Ying Li ◽  
Ting-Ting Jiang ◽  
Zeng-Mao Lin ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Abdominal Wall ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Renal Surgery ◽  
Postsurgical Pain

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery involving access through the lateral abdominal wall remains unknown. Therefore, the study aimed to evaluate 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) or control (C) groups. After anaesthesia 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 upon immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 h after surgery as well as recovery quality variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized: 53 and 51 in groups T and C, respectively. Laparoscopic surgery was converted to open surgery in one patient. Thus, he was excluded from the analysis. The median intraoperative and postoperative opioid consumption (oral morphine equivalent dose, o-MED) in the first 24 h after surgery were 105.0 and 32.5 mg in Group C, respectively, and the corresponding values in Group T were 121.0 and 39.7 mg, all of which were not significant (P = 0.284 and 0.311). Postsurgical pain intensity at all time points was comparable between the groups (all P > 0.05). Intergroup differences in the recovery quality variables were not significant (all P > 0.05). Conclusion Our findings demonstrated that preoperative lateral TAP could not decrease intraoperative or postoperative opioid consumption or 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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