The Role of Transversus Abdominis Plane Blocks in Enhanced Recovery After Surgery Pathways for Open and Laparoscopic Colorectal Surgery
| Autor: | Richard D. Urman, Alexander J. Kim, Robert Jason Yong |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Colon Analgesic MEDLINE Placebo Perioperative Care 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology medicine Humans Transversus abdominis Enhanced recovery after surgery Abdominal Muscles Pain Postoperative business.industry Rectum Nerve Block Multimodal therapy Colorectal surgery Surgery 030220 oncology & carcinogenesis Anesthesia Critical Pathways Laparoscopy business Abdominal surgery |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 27:909-914 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2017.0337 |
| Popis: | The concepts of Enhanced Recovery After Surgery (ERASWe performed an extensive literature search in MEDLINE and PubMed. We review the benefits of TAP blocks for colorectal surgery, both laparoscopic and open. We organize the data by surgery type, by method of TAP block performance, and by a comparison of TAP block to alternative analgesic techniques or to placebo. We examine different endpoints, such as postoperative pain, analgesic use, return of bowel function, and length of stay.The majority of studies examined TAP blocks in the context of laparoscopic colorectal surgery, with many, but not all, demonstrating significantly less use of postoperative opioids in comparison to placebo, wound infiltration, and standard postoperative patient-controlled analgesia with intravenous opioid administration. There is evidence that use of liposomal bupivacaine may be more effective than conventional long-acting local anesthetics. Noninferiority of TAP infusions has been demonstrated, compared with continuous thoracic epidural infusions.TAP blocks are easily performed, cost-effective, and an opioid-sparing adjunct for laparoscopic colorectal surgery, with minimal procedure-related morbidity. The evidence is in concordance with several of the goals of ERAS pathways. |
| Databáze: | OpenAIRE |
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