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.
|Number of pages||4|
|Journal||Annals of The Royal College of Surgeons of England|
|Publication status||Published - Jul 2012|
- Abdominal Muscles
- Analgesia, Patient-Controlled
- Analgesics, Opioid
- Anesthesia, Local
- Cohort Studies
- Colonic Neoplasms
- Conscious Sedation
- Length of Stay
- Nerve Block
- Pain, Postoperative
- Postoperative Care