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

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)327-30
Number of pages4
JournalAnnals of The Royal College of Surgeons of England
Volume94
Issue number5
DOIs
Publication statusPublished - Jul 2012

Keywords

  • Abdominal Muscles
  • Aged
  • Analgesia, Patient-Controlled
  • Analgesics, Opioid
  • Anesthesia, Local
  • Cohort Studies
  • Colectomy
  • Colonic Neoplasms
  • Conscious Sedation
  • Female
  • Humans
  • Length of Stay
  • Male
  • Morphine
  • Nerve Block
  • Pain, Postoperative
  • Postoperative Care

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