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Published in: International Journal of Colorectal Disease 9/2015

01-09-2015 | Original Article

Transversus abdominis plane blockade in laparoscopic colorectal surgery: a double-blind randomized clinical trial

Authors: Stephen Ridley Smith, Brian Draganic, Peter Pockney, Phillip Holz, Ryan Holmes, Brendan Mcmanus, Rosemary Carroll

Published in: International Journal of Colorectal Disease | Issue 9/2015

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Abstract

Introduction

Adequate postoperative analgesia is essential for recovery following colorectal surgery. Transversus abdominis plane (TAP) blocks have been found to be beneficial in improving pain following a variety of abdominal operations. The objective of this study was to determine if TAP blocks are useful in improving postoperative recovery following laparoscopic colorectal surgery.

Materials and methods

A prospective double-blind randomized clinical trial, involving 226 consecutive patients having laparoscopic colorectal surgery, was performed by a university colorectal surgical department. Patients were randomized to either TAP blockade using ultrasound guidance, or control, with the primary outcome being postoperative pain, as measured by analgesic consumption. Secondary outcomes assessed were pain visual analogue score (VAS), respiratory function, time to return of gut function, length of hospital stay, postoperative complications, and patient satisfaction.

Results

A total of 142 patients were followed up to trial completion (74 controls, 68 interventions). Patients were well matched with regard to demographics. No complications occurred as a result of the intervention of TAP blockade. There was no difference between groups with regards to analgesic consumption (161 mEq morphine control vs 175 mEq morphine TAP; p = 0.596). There was no difference between the two groups with regards to the secondary outcomes of daily VAS, respiratory outcome, time to return of gut function, length of hospital stay, postoperative complications, and patient satisfaction.

Conclusion

We conclude that TAP blockade appears to be a safe intervention but confers no specific advantage following laparoscopic colorectal surgery.
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Metadata
Title
Transversus abdominis plane blockade in laparoscopic colorectal surgery: a double-blind randomized clinical trial
Authors
Stephen Ridley Smith
Brian Draganic
Peter Pockney
Phillip Holz
Ryan Holmes
Brendan Mcmanus
Rosemary Carroll
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 9/2015
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-015-2286-7

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