Transversus abdominis plane block after laparoscopic colonic resection in cancer patients: A randomised clinical trial
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BACKGROUND: A key point in pathways for optimal rehabilitation and enhanced recovery is an effective postoperative multimodal pain treatment regimen.
OBJECTIVE: To investigate the analgesic effects of transversus abdominis plane (TAP) block in conjunction with paracetamol and ibuprofen in patients undergoing laparoscopic colonic resection.
DESIGN: Randomised placebo-controlled double-blind study.
SETTING: Herlev University Hospital, Copenhagen, Denmark, from March 2010 to February 2013.
PATIENTS: Eighty adult patients scheduled for elective laparoscopic colectomy.
INTERVENTIONS: Bilateral TAP block with 20 ml of either ropivacaine or isotonic saline.
MAIN OUTCOME MEASURES: Visual analogue scale (VAS) pain scores (0 to 100 mm) while coughing at 6 h after surgery (primary outcome). Secondary outcomes were area under the curve pain scores (2 to 24 h) at rest and while coughing, 24-h morphine consumption and incidence of nausea and vomiting.
RESULTS: VAS pain scores at 6 h while coughing was not different between groups (median, interquartile range), TAP, 27 (11 to 45) mm vs. placebo, 33 (20 to 49) mm (P = 0.20). Total 24-h morphine consumption was reduced in the TAP block group vs. placebo group, 30 (15 to 41) mg vs. 43 (30 to 67) mg, respectively (P = 0.008). This difference was most pronounced in the first postoperative hours. The remaining outcomes did not differ between groups.
CONCLUSION: TAP block used in combination with paracetamol and ibuprofen did not reduce pain after laparoscopic colonic surgery. However, we found a 30% reduction in opioid use, most marked in the early postoperative period.
TRIAL REGISTRATION: www.clinicaltrials.gov (NCT01418144).
Original language | English |
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Journal | European Journal of Anaesthesiology |
Volume | 33 |
Issue number | 10 |
Pages (from-to) | 725-30 |
Number of pages | 6 |
ISSN | 0265-0215 |
DOIs | |
Publication status | Published - Oct 2016 |
- Journal Article
Research areas
ID: 176610845