Sayed Mehdi Jalali1, Mohammad Hadi Bahri2, Seyed Mostafa Meshkati Yazd3, Mohamadreza Karoobi3, Niloufar Shababi3. 1. Department of Surgery, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Surgery, Shahid Madani Hospital, Faculty of Medicine, Alborz University of Medical Sciences, Alborz, Iran. m.bahri@abzums.ac.ir. 3. Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
PURPOSE: Transversus abdominis plane (TAP) block is a new option for reducing postoperative pain. This study investigated the effects of laparoscopic TAP block on postoperative adverse events and analgesia and antiemetics requirements after bariatric surgery. METHODS: In this randomized clinical trial study, patients were randomly divided into control (N = 20) or TAP block (N = 20) groups. In the TAP block group, the block was performed under direct laparoscopic guidance after surgery and before the removal of trocars. RESULTS: Fifteen patients (75%) versus four patients (20%) received opioids within the first 6 h in the control and TAP groups, respectively (p-value < 0.001). The cumulative amount of opioids consumed in the 24 and 48 h after surgery was lower in the TAP group (p-value < 0.001). The visual analog scale (VAS) regarding general and wound-specific pain was significantly lower in the TAP group compared to the control group at 6 and 24 h both at rest and in movement. However, there was no significant difference at 48 h postoperatively. The percentages of patients having postoperative nausea and vomiting (PONV), pruritus, and resumption of bowel movement were not significantly different between the two groups at any time (6, 24, and 48 h) postoperatively. CONCLUSION: Laparoscopic-guided TAP block is a pragmatic, applicable, and minimally invasive regional technique and can be part of effective postoperative pain management in morbidly obese patients undergoing bariatric surgery. Applying it laparoscopically without the need for ultrasound is also useful and effective.
PURPOSE: Transversus abdominis plane (TAP) block is a new option for reducing postoperative pain. This study investigated the effects of laparoscopic TAP block on postoperative adverse events and analgesia and antiemetics requirements after bariatric surgery. METHODS: In this randomized clinical trial study, patients were randomly divided into control (N = 20) or TAP block (N = 20) groups. In the TAP block group, the block was performed under direct laparoscopic guidance after surgery and before the removal of trocars. RESULTS: Fifteen patients (75%) versus four patients (20%) received opioids within the first 6 h in the control and TAP groups, respectively (p-value < 0.001). The cumulative amount of opioids consumed in the 24 and 48 h after surgery was lower in the TAP group (p-value < 0.001). The visual analog scale (VAS) regarding general and wound-specific pain was significantly lower in the TAP group compared to the control group at 6 and 24 h both at rest and in movement. However, there was no significant difference at 48 h postoperatively. The percentages of patients having postoperative nausea and vomiting (PONV), pruritus, and resumption of bowel movement were not significantly different between the two groups at any time (6, 24, and 48 h) postoperatively. CONCLUSION: Laparoscopic-guided TAP block is a pragmatic, applicable, and minimally invasive regional technique and can be part of effective postoperative pain management in morbidly obese patients undergoing bariatric surgery. Applying it laparoscopically without the need for ultrasound is also useful and effective.
Authors: Karen C Nielsen; Ulrich Guller; Susan M Steele; Stephen M Klein; Roy A Greengrass; Ricardo Pietrobon Journal: Anesthesiology Date: 2005-01 Impact factor: 7.892
Authors: Justin de V de Beer; Mitchell J Winemaker; Graeme A E Donnelly; Paula C Miceli; Joseph L Reiz; Zoltan Harsanyi; Lance W Payne; Andrew C Darke Journal: Can J Surg Date: 2005-08 Impact factor: 2.089
Authors: Alan R Schwartz; Susheel P Patil; Samuel Squier; Hartmut Schneider; Jason P Kirkness; Philip L Smith Journal: J Appl Physiol (1985) Date: 2009-10-29