Efficacy of ultrasound-guided Transversus Abdominis Plane (TAP) block in inguinal hernia surgery and the immunomodulatory effects of proinflammatory cytokines: prospective, randomized, placebo-controlled study
| Autor: | Nilay Taş, Ali Altinbas, Ahmet Gültekin, Ebru Canakci, Murat Cihan, Zubeyir Cebeci |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Neuroendocrine Stress-Response
Surgical stress Visual analogue scale Analgesic Placebo-controlled study Hernia Inguinal Proinflammatory cytokine Immunomodulation Transversus Abdominis Plane Block Anesthesiology Humans Medicine RD78.3-87.3 Prospective Studies Anesthetics Local Ultrasonography Interventional Pain control Abdominal Muscles Pain Measurement Bupivacaine Proinflammatory cytokines business.industry General Medicine Inguinal hernia surgery Analgesic Efficacy Anesthesia Transversus abdominis plane block Cytokines business Repair medicine.drug |
| Zdroj: | Brazilian Journal of Anesthesiology, Vol 71, Iss 5, Pp 538-544 (2021) Brazilian Journal of Anesthesiology, Issue: ahead, Published: 09 AUG 2021 |
| ISSN: | 0104-0014 |
| Popis: | Background: Tumor Necrosis Factor -a (TNF-a) and Interleukin-113 (IL-113) are among the cytokines released secondary to the surgical stress response. The objective of this study was to investigate the effect of a Transversus Abdominis Plane (TAP) block on postoperative pain and its immunomodulatory activity through proinflammatory cytokines. Methods: TAP (study group; n = 40) or p-TAP (placebo group; n = 40). Patients in the TAP group underwent an Ultrasound (US) guided unilateral TAP block using 20-cc 0.5% bupivacaine solution. Patients in the p-TAP group underwent a sham block using 20-cc isotonic solution. The TNF-a and IL-113 levels were measured three times at preoperative hour-0 and postoperative hours 4 and 24. Visual Analog Scale (VAS) scores were recorded at 0-hours, 30-minutes, 4-hours, and 24-hours. Analgesic use within the first 24-hours following surgery was monitored. Results: The postoperative VAS score was decreased in the TAP group at all time points (0, 4, and 24 hours), and the differences between groups were statistically significant (p < 0.001 for all comparisons). In the TAP group, the TNF-a and IL-113 levels at 4 and 24 hours post operation were significantly lower than the preoperative levels (p < 0.001 for all comparisons). Conclusion: The TAP block for pre-emptive analgesia enabled effective hemodynamic control during the intraoperative period, provided effective pain control in the postoperative period, and decreased inflammation and surgical stress due to the decreased levels of the proinflamma-tory cytokines TNF-ec and IL-1 beta in the first postoperative 24 hours, indicating immunomodulatory effect. (c) 2021 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). |
| Databáze: | OpenAIRE |
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