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. 2012 Jul;94(5):327-30.
doi: 10.1308/003588412X13171221589856.

Open transversus abdominis plane block and analgesic requirements in patients following right hemicolectomy

R R Brady  1 , N T Ventham, D M Roberts, C Graham, T Daniel
Affiliations

Open transversus abdominis plane block and analgesic requirements in patients following right hemicolectomy

R R Brady et al. Ann R Coll Surg Engl. 2012 Jul.

Abstract

Introduction: Reducing exogenously administered opioids in the post-operative period is associated with early return of bowel function and decreased post-operative complication rates. We evaluated the effectiveness of a surgeon-delivered open transversus abdominis plane (TAP) block as a method to reduce post-operative opioid requirements, sedation and inpatient stay.

Methods: The patient cohort was identified from those who had undergone a right hemicolectomy for colonic cancer. Patients received either an open TAP block and post-operative patient controlled anaesthesia (PCA) ( n =20) or were part of a control group who received subcutaneous local anaesthetic infiltration and PCA ( n =16).

Results: PCA morphine use was reduced within the first 24 hours post-operatively in the TAP block group compared with controls (42.1mg vs 72.3mg, p =0.002). Sedation was also reduced significantly in the early post-operative period (p <0.04). There was a non-significant trend towards reduced length of stay in the intervention group (8.2 vs 8.73 days). There were no recorded complications attributable to the open TAP block.

Conclusions: Open TAP blocks are safe and reduce post-operative opioid requirements and sedation after right hemicolectomies. They should be considered as part of a multimodal enhanced recovery approach to patients undergoing abdominal surgery via a transverse incision.

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Figures

Figure 1
Figure 1
The effect of transversus abdominis plane (TAP) block on mean post-operative morphine requirements (A) and the mean number of excessive sedation events (B) over 24 hours
See this image and copyright information in PMC

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