Tak Kyu Oh1, Jiyeon Yim2, Jaehyun Kim1, Woosik Eom1, Soon Ae Lee1, Sung Chan Park3, Jae Hwan Oh3, Ji Won Park4, Boram Park5, Dae Hyun Kim6. 1. Department of Anesthesiology and Pain Medicine, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. 2. Moonsan Central General Hospital, Paju, Republic of Korea. 3. Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. 4. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. 5. Biometric Research Branch, Research Institute and Hospital, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea. 6. Department of Anesthesiology and Pain Medicine, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. dhkim@ncc.re.kr.
Abstract
BACKGROUND: Although laparoscopic colorectal surgery decreases postoperative pain and facilitates a speedier recovery compared with laparotomy, postoperative pain at trocar insertion sites remains a clinical concern. The objective of this study was to assess the effects of a preoperative ultrasound-guided transversus abdominis plane (TAP) block on pain after laparoscopic surgery for colorectal cancer. METHODS: In total, 58 patients scheduled to undergo laparoscopic surgery following a diagnosis of colorectal cancer were included in this study. The patients were randomized into TAP and control groups; the TAP group patients received a preoperative ultrasound-guided bilateral TAP block with 0.5 mL/kg of 0.25 % bupivacaine, while the control patients received the block with an equal amount of saline. Pain on coughing and at rest was assessed during postanesthetic recovery (PAR; 1 h after surgery) and on postoperative days (PODs) 1 (24 h), 2 (48 h), and 3 (72 h) by an investigator blinded to group allocations using the numeric rating scale (NRS). The primary outcome was pain on coughing on postoperative day (POD) 1. RESULTS:Fifty-five patients were included in the final analysis, including 28 in the TAP and 27 in the control groups. The pain intensity on coughing and at rest during PAR and on PODs 1, 2, and 3 showed no significant differences between groups. Furthermore, there was no significant difference in postoperative opioid consumption, sedation scores, nausea scores at the four time points, complication rates, and length of hospital stay between groups. CONCLUSIONS: In colorectal cancer patients undergoinglaparoscopic colorectal surgery, a TAP block did not offer enough benefit for clinical efficacy in terms of postoperative pain or analgesic consumption.
RCT Entities:
BACKGROUND: Although laparoscopic colorectal surgery decreases postoperative pain and facilitates a speedier recovery compared with laparotomy, postoperative pain at trocar insertion sites remains a clinical concern. The objective of this study was to assess the effects of a preoperative ultrasound-guided transversus abdominis plane (TAP) block on pain after laparoscopic surgery for colorectal cancer. METHODS: In total, 58 patients scheduled to undergo laparoscopic surgery following a diagnosis of colorectal cancer were included in this study. The patients were randomized into TAP and control groups; the TAP group patients received a preoperative ultrasound-guided bilateral TAP block with 0.5 mL/kg of 0.25 % bupivacaine, while the control patients received the block with an equal amount of saline. Pain on coughing and at rest was assessed during postanesthetic recovery (PAR; 1 h after surgery) and on postoperative days (PODs) 1 (24 h), 2 (48 h), and 3 (72 h) by an investigator blinded to group allocations using the numeric rating scale (NRS). The primary outcome was pain on coughing on postoperative day (POD) 1. RESULTS: Fifty-five patients were included in the final analysis, including 28 in the TAP and 27 in the control groups. The pain intensity on coughing and at rest during PAR and on PODs 1, 2, and 3 showed no significant differences between groups. Furthermore, there was no significant difference in postoperative opioid consumption, sedation scores, nausea scores at the four time points, complication rates, and length of hospital stay between groups. CONCLUSIONS: In colorectal cancerpatients undergoing laparoscopic colorectal surgery, a TAP block did not offer enough benefit for clinical efficacy in terms of postoperative pain or analgesic consumption.
Authors: Jens Børglum; Kenneth Jensen; Anders F Christensen; Lotte C G Hoegberg; Sys S Johansen; P-A Lönnqvist; Tejs Jansen Journal: Reg Anesth Pain Med Date: 2012 May-Jun Impact factor: 6.288
Authors: Gildasio S De Oliveira; Lucas Jorge Castro-Alves; Autoun Nader; Mark C Kendall; Robert J McCarthy Journal: Anesth Analg Date: 2014-02 Impact factor: 5.108
Authors: Catherine J Walter; Charles Maxwell-Armstrong; Thomas D Pinkney; Philip J Conaghan; Nigel Bedforth; Christopher B Gornall; Austin G Acheson Journal: Surg Endosc Date: 2013-02-07 Impact factor: 4.584
Authors: Deborah S Keller; Bridget O Ermlich; Nicholas Schiltz; Bradley J Champagne; Harry L Reynolds; Sharon L Stein; Conor P Delaney Journal: Dis Colon Rectum Date: 2014-11 Impact factor: 4.585
Authors: Amy Copperthwaite; Shaheel Mohammad Sahebally; Zeeshan Muhammad Raza; Liam Devane; Niamh McCawley; David Kearney; John Burke; Deborah McNamara Journal: Ir J Med Sci Date: 2022-05-02 Impact factor: 1.568