Email this article Effectiveness of transverse abdominis plane blocks in abdominal surgery in hernioplasty
- Authors: Sorsunov S.V.1, Efimenko M.Y.1, Gritsan A.I.2
-
Affiliations:
- Regional Clinical Hospital
- Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky
- Issue: Vol 15, No 3 (2021)
- Pages: 223-232
- Section: Original study articles
- Submitted: 13.04.2022
- Accepted: 13.04.2022
- Published: 15.07.2021
- URL: https://rjraap.com/1993-6508/article/view/106248
- DOI: https://doi.org/10.17816/RA106248
- ID: 106248
Cite item
Open Access
Access granted
Abstract
BACKGROUND: Transverse abdominis plane (TAP) block is one of the methods of regional anesthesia, which is characterized by injecting a large volume of anesthetic into the fascial space between the internal oblique and transverse abdominal muscles that contains the nerves from Th7 to L1.
THIS STUDY AIMED to study the effectiveness and safety of TAP block in hernioplasty and conduct a comparative analysis of the TAP block with general anesthesia and extended epidural anesthesia.
MATERIALS AND METHODS: A comparative analysis of 78 patients who underwent hernioplasty was carried out. Patients are divided into three groups (n=26) depending on the features of the anesthesiological aid. The control group had a surgery that was performed in a multicomponent-combined anesthesia setting with total myoplegia and ALV. Group 1 had general anesthesia that was supplemented by TAP, a unit under the United States navigation. Group 2 had general anesthesia in combination with an extended epidural block. The need for narcotic analgesics and the severity of pain syndrome in the perioperative period were determined in the three groups to assess the effectiveness and safety of the method and compare the hemodynamic parameters. The severity of pain syndrome was determined using a visual analog scale (ALV). Changes in hemodynamic parameters were compared to evaluate the safety of the TAP block. The groups were comparable in terms of volume of surgery, age, and sex.
STUDY RESULTS: The need for narcotic analgesics was significantly lower in patients in groups 1 and 2 in intra- and postoperative periods than in the control group. Hemodynamic indicators (blood pressure and HS) were characterized by greater stability without significant fluctuations at all major stages of surgery, which indicates the development of adequate analgesia. A significantly decreased intensity of pain syndrome in the group of patients with a TAP block and extended EA was also noted.
CONCLUSION: Performing a bilateral TAB unit under ultrasound navigation in hernioplasty is an effective and safe method of perioperative pain relief of patients, which in most cases is a preferred alternative to extended EA.
Full Text
About the authors
Sergey V. Sorsunov
Regional Clinical Hospital
Author for correspondence.
Email: sorsunov.sergey@yandex.ru
ORCID iD: 0000-0002-7116-9925
Candidate of Medical Sciences
Russian Federation, KrasnoyarskMaxim Yu. Efimenko
Regional Clinical Hospital
Email: ef.max.yu@gmail.com
ORCID iD: 0000-0003-1516-7877
anesthesiologist- intensivist
Russian Federation, KrasnoyarskAlexey I. Gritsan
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky
Email: gritsan67@mail.ru
ORCID iD: 0000-0002-0500-2887
Doctor of Medical Sciences; Professor
Russian Federation, KrasnoyarskReferences
- Tsai HC, Yoshida T, Chuang TY, et al. Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017;2017:8284363. doi: 10.1155/2017/8284363
- Hebbard P, Fujiwara Y, Shibata Y, Royse C. Ultrasound-guided transversus abdominis plane (TAP) block. Anaesth Intensive Care. 2007;35(4):616–617.
- Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg. 2013;37(2):259–284. doi: 10.1007/s00268-012-1772-0
- Fields AC, Gonzalez DO, Chin EH, et al. Laparoscopic-Assisted Transversus Abdominis Plane Block for Postoperative Pain Control in Laparoscopic Ventral Hernia Repair: A Randomized Controlled Trial. J Am Coll Surg. 2015;221(2):462–469. doi: 10.1016/j.jamcollsurg.2015.04.007
- Paasch C, Aljedani N, Ortiz P, et al. The transversus abdominis plane block may reduce early postoperative pain after laparoscopic ventral hernia repair a matched pair analysis. Ann Med Surg (Lond). 2020;55:294–299. doi: 10.1016/j.amsu.2020.05.044
- Chesov I, Belii A. Postoperative analgesic efficiency of transversus abdominis plane block after ventral hernia repair: a prospective, randomized, controlled clinical trial. Rom J Anaesth Intensive Care. 2017;24(2):125–132. doi: 10.21454/rjaic.7518.242.chv
- Gan TJ, Habib AS, Miller TE, et al. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014;30(1):149–160. doi: 10.1185/03007995.2013.860019
- Ovechkin AM, Bayalieva AZ, Ezhevskaya AA, et al. Postoperative analgesia. Annals of Critical Care. 2019(4):9–33. (In Russ). doi: 10.21320/1818-474x-2019-4-9-33
- Falk W, Gupta A, Forssten MP, et al. Epidural analgesia and mortality after colorectal cancer surgery: A retrospective cohort study. Ann Med Surg (Lond). 2021;66:102414. doi: 10.1016/j.amsu.2021.102414
- Ovechkin AM. Postoperative pain: the state of problem and current trends in postoperative analgesia. Regional anesthesia and acute pain management. 2015;9(2):29–39. (In Russ).
- Kehlet H. Postoperative pain, analgesia, and recovery-bedfellows that cannot be ignored. Pain. 2018;159 Suppl 1:S11–S16. doi: 10.1097/j.pain.0000000000001243
- Pasechnik IN, Timashkov DA, Skobelev EI. Postoperative analgesia: realities and prospects. Khirurgiia (Mosk). 2018(7):62–66. (In Russ). doi: 10.17116/hirurgia2016762-66
- Garimella V, Cellini C. Postoperative pain control. Clin Colon Rectal Surg. 2013;26(3):191–196. doi: 10.1055/s-0033-1351138
- Bessmertnyj AE, Antipin EE, Uvarov DN, et al. Comparison of the effectiveness of ilioinguinal-iliohypogastric blockade and transversus abdominis plane block for analgesia after cesarean section. Russian journal of anaesthesiology and reanimatology. 2015;60(2):51–55. (In Russ).
- Yu N, Long X, Lujan-Hernandez JR, et al. Transversus abdominis-plane block versus local anesthetic wound infiltration in lower abdominal surgery: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol. 2014;14:121. doi: 10.1186/1471-2253-14-121
- Ripolles J, Mezquita SM, Abad A, Calvo J. Analgesic efficacy of the ultrasound-guided blockade of the transversus abdominis plane – a systematic review. Braz J Anesthesiol. 2015;65(4):255–280. doi: 10.1016/j.bjane.2013.10.016
- Sizonenko NA, Surov DA, Solov’ev IA, et al. [Evolution of enhanced recovery after surgery: from the beginning of the study of stress to the introduction in emergency surgery]. Khirurgiia (Mosk). 2018(11):71–79. (In Russ). doi: 10.17116/hirurgia201811171
- phlebounion.ru [Internet]. Andriyashkin AV, Andriyashkin VV, Arutyunov GP, et al. Rossiiskie klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike VTEO, 2015 g. Kod versii (ID): 1_2015 [cited 05 November 2021]. Available from: https://phlebounion.ru/recommendations/rossiyskiye-klinicheskiye-rekomendatsii-po-diagnostike-lecheniyu-i-profilaktike-venoznykh-tromboembo#header-3
- Koryachkin VA, Chupris VG, Cherny AZh, et al. Systemic toxisity of local anesthethics during regional anesthesia in orthopedics and traumatology. Traumatology And Orthopedics Of Russia. 2015;21(1):129–135. (In Russ).
Supplementary files
