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Boran ÖF, Urfalioglu A, Arslan M, Yazar FM, Bilal B, Orak Y, Katı B, Bozan AA. The effect of transversus abdominis plane block application on postoperative analgesia quality and patient satisfaction after varicocele surgery: a randomized clinical trial. ASIAN BIOMED 2023; 17:136-143. [PMID: 37818162 PMCID: PMC10561680 DOI: 10.2478/abm-2023-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Background Postoperative pain management is an important aspect of anesthesia care and multimodal analgesic techniques are generally recommended. Objective To compare the effect of spinal anesthesia + transversus abdominis plane (TAP) block application on postoperative analgesia quality and patient satisfaction with spinal anesthesia + intrathecal morphine (ITM) application. Methods A total of 70 patients were randomly separated into 2 groups as spinal anesthesia + TAP block (TAP block group, n = 34) and spinal anesthesia + ITM group (ITM group, n = 36). The groups were compared in respect of age, body mass index values, and visual analog scale (VAS) values at 0 h, 2 h, 6 h, 12 h, and 18 h, and patient satisfaction was scored by Quality Improvement in Postoperative Pain Management at 24 h. Results The mean age of the patients was 32.52 ± 6.50 years in the TAP block group and 30.11 ± 5.62 years in the ITM group, with no statistically significant difference determined. There was no statistically significant difference in terms of VAS values at 0 h, 2 h, 6 h, 12 h, and 18 h. When the factors affecting postoperative patient satisfaction were evaluated, feeling fatigue after the surgery (r = -0.811, P = 0.001) and postoperative complications such as nausea, vomiting, and itching (r = -0.831, P = 0.001) were found to have a negative effect on patient satisfaction. Conclusion Due to low complication rates, TAP block is an effective application for postoperative analgesia management in varicocele operations that increases patient satisfaction postoperatively.
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Affiliation(s)
- Ömer Faruk Boran
- Department of Anesthesiology and Reanimation, Sütçü Imam University School of Medicine, Kahramanmaraş46000, Turkey
| | - Aykut Urfalioglu
- Department of Anesthesiology and Reanimation, Sütçü Imam University School of Medicine, Kahramanmaraş46000, Turkey
| | - Mahmut Arslan
- Department of Anesthesiology and Reanimation, Sütçü Imam University School of Medicine, Kahramanmaraş46000, Turkey
| | - Fatih Mehmet Yazar
- Department of General Surgery, Sütçü Imam University School of Medicine, Kahramanmaraş46000, Turkey
| | - Bora Bilal
- Department of Anesthesiology and Reanimation, Sütçü Imam University School of Medicine, Kahramanmaraş46000, Turkey
| | - Yavuz Orak
- Department of Anesthesiology and Reanimation, Sütçü Imam University School of Medicine, Kahramanmaraş46000, Turkey
| | - Bülent Katı
- Department of Urology, Harran University School of Medicine, Şanlıurfa, Kahramanmaraş63000, Turkey
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Jones JH, Aldwinckle R. Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review. Local Reg Anesth 2020; 13:159-169. [PMID: 33122942 PMCID: PMC7591028 DOI: 10.2147/lra.s272694] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022] Open
Abstract
Laparoscopic abdominal surgery has become a mainstay of modern surgical practice. Postoperative analgesia is an integral component of recovery following laparoscopic abdominal surgery and may be improved by regional anesthesia or intravenous lidocaine infusion. There is inconsistent evidence supporting the use of interfascial plane blocks, such as transversus abdominis plane (TAP) blocks, for patients undergoing laparoscopic abdominal surgery as evidenced by variable patterns of local anesthetic spread and conflicting results from studies comparing TAP blocks to local anesthetic infiltration of laparoscopic port sites and multimodal analgesia. Quadratus lumborum (QL) and erector spinae plane (ESP) blocks may provide greater areas of somatic analgesia as well as visceral analgesia, which may translate to more significant clinical benefits. Aside from the locations of the surgical incisions, it is unclear what other factors should be considered when choosing one regional technique over another or deciding to infuse lidocaine intravenously. We reviewed the current literature in attempt to clarify the roles of various regional anesthesia techniques for patients undergoing laparoscopic abdominal surgery and present one possible approach to evaluating postoperative pain.
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Affiliation(s)
- James Harvey Jones
- Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Robin Aldwinckle
- Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, Sacramento, CA, USA
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Peltrini R, Cantoni V, Green R, Greco PA, Calabria M, Bucci L, Corcione F. Efficacy of transversus abdominis plane (TAP) block in colorectal surgery: a systematic review and meta-analysis. Tech Coloproctol 2020; 24:787-802. [PMID: 32253612 DOI: 10.1007/s10151-020-02206-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 03/31/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Multimodal opioid-sparing analgesia is a key component of the enhanced recovery after surgery (ERAS) protocol for postoperative pain management. Transversus abdominis plane (TAP) block has contributed to the implementation of this approach in different kinds of surgical procedures. The aim of this study was to evaluate the efficacy of TAP block and its impact on recovery in colorectal surgery. METHODS A comprehensive literature search of the PubMed, Embase, and Scopus databases was conducted. Studies that compared TAP block to a control group (no TAP block or placebo) after colorectal resections were included. The effects of TAP block in patients undergoing colorectal surgery were assessed, including the technical aspects of the procedure. Two measures were used to evaluate the effectiveness of postoperative pain control: a numeric pain rating score at rest and on coughing or movement at 24 h following surgery and the opioid requirement at 24 h. Clinical aspects of recovery were postoperative ileus, surgical site infection, postoperative nausea and vomiting, and length of hospital stay. RESULTS Sixteen studies were included in the analysis. Data showed that TAP block is a safe procedure associated with a significant reduction in the pain score at rest [WMD - 0.91 (95% CI - 1.56; - 0.27); p < 0.05] and on coughing or movement [WMD - 0.36 (95% CI - 0.72; - 0.01); p < 0.05] at 24 h after surgery and a significant decrease in morphine consumption in the TAP block group the day after surgery [WMD - 2.07 (95% CI - 2.63; - 1.51); p < 0.001]. CONCLUSIONS TAP block appears to provide both an effective analgesia and a significant reduction in opioid use on the first postoperative day after colorectal surgery. Its use does not seem to lead to increased postoperative complications.
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Affiliation(s)
- R Peltrini
- Department of Public Health, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - V Cantoni
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - R Green
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - P A Greco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Calabria
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - L Bucci
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - F Corcione
- Department of Public Health, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
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Colibaseanu DT, Osagiede O, Merchea A, Ball CT, Bojaxhi E, Panchamia JK, Jacob AK, Kelley SR, Naessens JM, Larson DW. Randomized clinical trial of liposomal bupivacaine transverse abdominis plane block versus intrathecal analgesia in colorectal surgery. Br J Surg 2019; 106:692-699. [DOI: 10.1002/bjs.11141] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/20/2018] [Accepted: 01/06/2019] [Indexed: 01/07/2023]
Abstract
Abstract
Background
Transverse abdominis plane (TAP) block is considered an effective alternative to neuraxial analgesia for abdominal surgery. However, limited evidence supports its use over traditional analgesic modalities in colorectal surgery. This study compared the analgesic efficacy of liposomal bupivacaine TAP block with intrathecal (IT) opioid administration in a multicentre RCT.
Methods
Patients undergoing elective small bowel or colorectal resection were randomized to receive TAP block or a single injection of IT analgesia with hydromorphone. Patients were assessed at 4, 8, 16, 24 and 48 h after surgery. Primary outcomes were mean pain scores and morphine milligram equivalents (MMEs) administered within 48 h after surgery. Secondary outcomes included duration of hospital stay, incidence of postoperative ileus and use of intravenous patient-controlled analgesia.
Results
In total, 209 patients were recruited and 200 completed the trial (TAP 102, IT 98). The TAP group had a 1·6-point greater mean pain score than the IT group at 4 h after surgery, and this difference lasted for 16 h after operation. The TAP group received more MMEs within the first 24 h after surgery than the IT group (median difference in MMEs 10·0, 95 per cent c.i. 3·0 to 20·5). There were no differences in MME use at 24 and 48 h, or with respect to secondary outcomes.
Conclusion
IT opioid administration provided better immediate postoperative pain control than TAP block. Both modalities resulted in low pain scores in patients undergoing elective colorectal surgery and should be considered in multimodal postoperative analgesic plans. Registration number: NCT02356198 ( http://www.clinicaltrials.gov).
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Affiliation(s)
- D T Colibaseanu
- Department of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, Florida, USA
| | - O Osagiede
- Department of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, Florida, USA
| | - A Merchea
- Department of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, Florida, USA
| | - C T Ball
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida, USA
| | - E Bojaxhi
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - J K Panchamia
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - A K Jacob
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - S R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - J M Naessens
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA
| | - D W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Quadratus Lumborum Block Versus Perioperative Intravenous Lidocaine for Postoperative Pain Control in Patients Undergoing Laparoscopic Colorectal Surgery. Ann Surg 2018; 268:769-775. [DOI: 10.1097/sla.0000000000002888] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Xue Y, Yuan H, Chen Y. Effects of dexmedetomidine as an adjunct in transversus abdominis plane block during gynecological laparoscopy. Exp Ther Med 2018; 16:1131-1136. [PMID: 30116363 PMCID: PMC6090381 DOI: 10.3892/etm.2018.6295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 05/02/2018] [Indexed: 12/11/2022] Open
Abstract
Ultrasound-guided transversus abdominis plane (TAP) block for abdominal surgery has been widely studied in clinical settings. However, dexmedetomidine as an adjunctive analgesic combined with TAP block has been rarely reported. The present study evaluated the efficacy of TAP block combined with dexmedetomidine adjunct for gynecological laparoscopy. In brief, 90 patients were randomly divided into three groups: Group I, which received post-operative intravenous analgesia only after general anesthesia; Group II, which received a TAP block with 20 ml 0.375% ropivacaine; and Group III, which received a TAP block with 20 ml of 0.375% ropivacaine and 1 µg/kg dexmedetomidine after induction. In all groups, propofol was used for general anesthesia. The dosage of propofol, duration of the operation, and the time of awakening, spontaneous breathing and extubation were recorded. In addition, the Steward and visual analogue scale (VAS) scores were determined at 2, 4, 8, 12 and 24 h post-surgery. The occurrence of nausea and vomiting and/or respiratory depression was also recorded. Compared with those in Group I, the dosage of propofol, as well as the time of awakening, spontaneous breathing and extubation were significantly decreased in Group III (P<0.01 and P<0.05, respectively). In addition, the VAS score at 2 and 4 h in Group II (both P<0.05) and 2, 4 (both P<0.01) and 8 h (P<0.05) in Group III after the surgery were significantly lower compared with those in Group I. Furthermore, in Groups II and III, a lower number of cases experienced nausea and vomiting (P<0.05). In conclusion, the ultrasound-guided TAP block combined with dexmedetomidine adjunct may improve recovery from anesthesia and reduce post-operative pain (trial registration no. ChiCTR-IPR-15007398).
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Affiliation(s)
- Yurong Xue
- Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Hui Yuan
- Department of Anesthesiology, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315000, P.R. China
| | - Yongquan Chen
- Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
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Oh TK, Lee SJ, Do SH, Song IA. Transversus abdominis plane block using a short-acting local anesthetic for postoperative pain after laparoscopic colorectal surgery: a systematic review and meta-analysis. Surg Endosc 2017; 32:545-552. [DOI: 10.1007/s00464-017-5871-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 09/04/2017] [Indexed: 01/05/2023]
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Nagata J, Watanabe J, Sawatsubashi Y, Akiyama M, Arase K, Minagawa N, Torigoe T, Hamada K, Nakayama Y, Hirata K. A novel transperitoneal abdominal wall nerve block for postoperative pain in laparoscopic colorectal surgery. Asian J Surg 2017; 41:417-421. [PMID: 28389063 DOI: 10.1016/j.asjsur.2017.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/10/2017] [Accepted: 02/17/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although the laparoscopic approach reduces pain associated with abdominal surgery, postoperative pain remains a problem. Ultrasound-guided rectus sheath block and transversus abdominis plane block have become increasingly popular means of providing analgesia for laparoscopic surgery. METHODS Ninety patients were enrolled in this study. A laparoscopic puncture needle was inserted via the port, and levobupivacaine was injected into the correct plane through the peritoneum. The patients' postoperative pain intensity was assessed using a numeric rating scale. The effects of laparoscopic nerve block versus percutaneous anesthesia were compared. RESULTS This novel form of transperitoneal anesthesia did not jeopardize completion of the operative procedures. The percutaneous approach required more time for performance of the procedure than the transperitoneal technique. CONCLUSION This new analgesia technique can become an optional postoperative treatment regimen for various laparoscopic abdominal surgeries. What we mainly want to suggest is that the transperitoneal approach has the advantage of a higher completion rate. A percutaneous technique is sometimes difficult with patients who have severe obesity and/or coagulation disorders. Additional studies are required to evaluate its benefits.
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Affiliation(s)
- Jun Nagata
- Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan.
| | - Jun Watanabe
- Department of Surgery, Yokosuka Kyosai Hospital, Kanagawa, Japan
| | - Yusuke Sawatsubashi
- Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Masaki Akiyama
- Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Koichi Arase
- Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Noritaka Minagawa
- Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Takayuki Torigoe
- Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Kotaro Hamada
- Department of Anesthesiology, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yoshifumi Nakayama
- Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Keiji Hirata
- Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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10
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Keller DS, Madhoun N, Ponte-Moreno OI, Ibarra S, Haas EM. Transversus abdominis plane blocks: pilot of feasibility and the learning curve. J Surg Res 2016; 204:101-8. [DOI: 10.1016/j.jss.2016.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 03/24/2016] [Accepted: 04/13/2016] [Indexed: 11/30/2022]
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