Ultrasound-guided transversus abdominis plane block for postoperative analgesia in living liver donors: A prospective, randomized, double-blinded clinical trial

Abstract Background Transversus abdominis plane (TAP) block is a peripheral nerve block that reduces postoperative pain, nausea, vomiting and the need for postoperative opioids following various types of abdominal surgery. The primary aim of the present study was to evaluate the effects of TAP block...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2017-02, Vol.37, p.103-107
Main Authors: Kıtlık, Arzu, Erdogan, Mehmet Ali, Ozgul, Ulku, Aydogan, Mustafa Said, Ucar, Muharrem, Toprak, Huseyin Ilksen, Colak, Cemil, Durmus, Mahmut
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Muscles
Abdominal surgery
Adult
Analgesia, Patient-Controlled - methods
Analgesics
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - therapeutic use
Anesthesia
Anesthesia & Perioperative Care
Anesthetics, Local - administration & dosage
Anesthetics, Local - therapeutic use
Antiemetics - administration & dosage
Antiemetics - therapeutic use
Blood & organ donations
Bupivacaine - administration & dosage
Bupivacaine - therapeutic use
Clinical trials
Double-Blind Method
Drug dosages
Hepatectomy - adverse effects
Humans
Liver
Living Donors
Living liver donor
Morphine - administration & dosage
Morphine - therapeutic use
Nerve Block - methods
Pain
Pain Management - methods
Pain Measurement
Pain Medicine
Pain, Postoperative - drug therapy
Patients
Postoperative Nausea and Vomiting - drug therapy
Postoperative Nausea and Vomiting - prevention & control
Postoperative pain
Postoperative period
Prospective Studies
Studies
Tissue and Organ Harvesting - adverse effects
Transversus abdominis plane block
Ultrasonic imaging
Ultrasonography, Interventional
Vomiting
Young Adult
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Summary:Abstract Background Transversus abdominis plane (TAP) block is a peripheral nerve block that reduces postoperative pain, nausea, vomiting and the need for postoperative opioids following various types of abdominal surgery. The primary aim of the present study was to evaluate the effects of TAP block on postoperative analgesia and opioid consumption in living liver donors in whom a right “J” abdominal incision was used. Methods This prospective, double-blinded, randomized controlled study was conducted with 50 living liver donors, aged 18–65 years, who were scheduled to undergo right hepatectomy. Patients who received ultrasonography-guided subcostal TAP block were allocated into Group 1, and patients who did not receive TAP block were allocated into Group 2. The TAP blocks were performed bilaterally at the conclusion of surgery using 1.5 mg ∗ kg − 1 bupivacaine diluted with saline to reach a total volume of 40 mL. For each patient, morphine consumption, pain scores at rest and movement, sedation scores, nausea, vomiting and the need for antiemetic medication were assessed at 0, 2, 4, 6, 12 and 24 h postoperatively by researchers who were blinded to the study groups. Results Morphine consumption was significantly lower in Group 1 than in Group 2 at the 2nd, 6th and 24th hours ( P < 0.05). The mean total morphine consumption values after 24 h were 40 mg and 65 mg in Groups 1 and 2, respectively. The TAP block significantly reduced postoperative visual analog scale pain scores both at rest and during movement at 0, 2, 4, 6, and 24 h postoperatively ( P < 0.05). Conclusions The TAP block reduced 24-h postoperative morphine consumption and contributed to analgesia in living liver donors who underwent upper abdominal wall incisions.
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2016.12.018