Transversus abdominis plane block after laparoscopic colonic resection in cancer patients
| Autor: | Ole Mathiesen, Mikkel Bøgeskov, Anja U. Mitchell, Ann Merete Møller, Egon G. Hansen, Jacob Rosenberg, Jørgen B. Dahl, Henrik Torup, Pernille L. Petersen |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Visual analogue scale Denmark medicine.medical_treatment Analgesic Ibuprofen Placebo 03 medical and health sciences 0302 clinical medicine Double-Blind Method 030202 anesthesiology Transversus Abdominis Plane Block Humans Medicine Colectomy Abdominal Muscles Acetaminophen Aged Pain Postoperative business.industry Ropivacaine Nerve Block Middle Aged Surgery Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Colonic Neoplasms Nerve block Vomiting Female Laparoscopy medicine.symptom business medicine.drug |
| Zdroj: | European Journal of Anaesthesiology. 33:725-730 |
| ISSN: | 0265-0215 |
| Popis: | 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). |
| Databáze: | OpenAIRE |
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