TY - JOUR
T1 - Continuous transversus abdominis plane block catheter analgesia for postoperative pain control in renal transplant
AU - Farag, Ehab
AU - Guirguis, Maged N.
AU - Helou, Mada
AU - Dalton, Jarrod E.
AU - Ngo, Fallon
AU - Ghobrial, Michael
AU - O’Hara, Jerome
AU - Seif, John
AU - Krishnamurthi, Venkatesh
AU - Goldfarb, David
N1 - Publisher Copyright:
© 2014, Japanese Society of Anesthesiologists.
PY - 2014/2
Y1 - 2014/2
N2 - Purpose: Continuous transversus abdominis plane (TAP) block using a catheter has proven its usefulness in reducing opioid requirements and pain scores after lower abdominal surgery. However, there are no reports of its successful use after renal transplant. We tested the hypothesis that continuous TAP block would retrospectively reduce opioid requirement, nausea score and hospital stay after renal transplant surgery.Methods: In a retrospective study, we reviewed the data from 63 adult renal transplant recipients—31 with patient-controlled TAP analgesia with standing orders for intravenous as well as oral opioids as needed and 32 with intravenous patient-controlled analgesia. The TAP catheter was inserted preoperatively using an ultrasound-guided technique. Infusion of ropivacaine 0.2 % at 8 ml basal, 12 ml bolus and a lockout interval of 60 min were maintained for 48 h postoperatively. The primary outcome was total morphine-equivalent dose during the 48-h postoperative period. Secondary outcomes were pain and nausea scores for the 48-h postoperative period.Results: The mean 48-h postoperative morphine-equivalent doses [95 % confidence interval] for patient-controlled intravenous analgesia and TAP catheter were 197 [111, 349] and 50 [28, 90], respectively, which were significantly different (P = 0.002). The mean 48-h average verbal response pain scores were 2.94 [2.39, 3.50] and 2.49 [1.93, 3.06], respectively, which were not significantly different (P = 0.26). The mean nausea scores were 0.66 [0.46, 0.87] and 0.60 [0.40, 0.81], respectively, which were not significantly different (P = 0.69). There was no difference regarding hospital stay.Conclusion: The use of continuous TAP analgesia for postoperative analgesia after renal transplant was effective in reducing the morphine-equivalent requirements.
AB - Purpose: Continuous transversus abdominis plane (TAP) block using a catheter has proven its usefulness in reducing opioid requirements and pain scores after lower abdominal surgery. However, there are no reports of its successful use after renal transplant. We tested the hypothesis that continuous TAP block would retrospectively reduce opioid requirement, nausea score and hospital stay after renal transplant surgery.Methods: In a retrospective study, we reviewed the data from 63 adult renal transplant recipients—31 with patient-controlled TAP analgesia with standing orders for intravenous as well as oral opioids as needed and 32 with intravenous patient-controlled analgesia. The TAP catheter was inserted preoperatively using an ultrasound-guided technique. Infusion of ropivacaine 0.2 % at 8 ml basal, 12 ml bolus and a lockout interval of 60 min were maintained for 48 h postoperatively. The primary outcome was total morphine-equivalent dose during the 48-h postoperative period. Secondary outcomes were pain and nausea scores for the 48-h postoperative period.Results: The mean 48-h postoperative morphine-equivalent doses [95 % confidence interval] for patient-controlled intravenous analgesia and TAP catheter were 197 [111, 349] and 50 [28, 90], respectively, which were significantly different (P = 0.002). The mean 48-h average verbal response pain scores were 2.94 [2.39, 3.50] and 2.49 [1.93, 3.06], respectively, which were not significantly different (P = 0.26). The mean nausea scores were 0.66 [0.46, 0.87] and 0.60 [0.40, 0.81], respectively, which were not significantly different (P = 0.69). There was no difference regarding hospital stay.Conclusion: The use of continuous TAP analgesia for postoperative analgesia after renal transplant was effective in reducing the morphine-equivalent requirements.
KW - Abdominal surgery
KW - Kidney transplantation
KW - Local anesthetic − ropivacaine
KW - Nausea
KW - Opioid analgesics − morphine
KW - TAP catheter
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U2 - 10.1007/s00540-014-1855-1
DO - 10.1007/s00540-014-1855-1
M3 - Article
C2 - 24898186
AN - SCOPUS:84937208009
SN - 0913-8668
VL - 29
SP - 4
EP - 8
JO - Journal of Anesthesia
JF - Journal of Anesthesia
IS - 1
ER -