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2024, Number 4

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Rev Mex Anest 2024; 47 (4)

Comparative analysis of transverse abdominal plane blockade and intravenous analgesia in open abdominal surgery: perspective from the Pain Out methodology

Rascón-Martínez DM, Aburto-Monzalvo H, Ojeda-Ramírez L, Adan-Nuñez EE, Delgadillo-Téllez BZ, González-Prior JM, Ortiz-Sánchez L, Cantellano-de MS, Ortiz-Higareda V

Language: Spanish
References: 25
Page: 251-256
PDF size: 261.34 Kb.


ABSTRACT

Introduction: currently, the inclusion of abdominal wall block techniques, particularly the transversus abdominis plane (TAP) block, has gained significance for the management of postoperative abdominal pain. Objective: to compare the analgesia provided by TAP block versus intravenous analgesia to control postoperative pain following open abdominal surgery based on the Pain Out methodology. Material and methods: a comparative, longitudinal, and retrospective analysis was conducted on the outcomes from a database generated by the Pain Out México study, including 60 patients who underwent open abdominal surgery. The groups included: a) TAP block and b) intravenous analgesia. We evaluated analgesic outcomes at 24 hours by comparing analgesic requirement, pain intensity at rest/movement, respiration, sleep quality, post-surgical activities, ambulation, adverse effects, percentage of perceived pain relief, and satisfaction, among others. Results: the TAP block group required fewer analgesics, exhibited increased post-surgical activity such as in-bed mobility, respiration, and ambulation, and had fewer adverse effects compared to the intravenous analgesia group. Conclusion: the TAP block provides more significant analgesic benefits and fewer adverse effects than opioid-based intravenous analgesia for postoperative pain management in patients undergoing open abdominal surgery.


REFERENCES

  1. Weiser T, Haynes A, Molina G, Esquivel M, Uribe t, Azad T, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet. 2015;385:11-18.

  2. Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;25:2287-229.

  3. Carrillo O, Brito R. Problemática actual de dolor crónico por insuficiente manejo de dolor agudo posoperatorio. Rev Mex Anestesiol. 2019;42:173-174.

  4. Sada-Ovalle T, Delgado-Hernández E, Castellanos-Olivares A. Prevalencia del dolor postoperatorio en cirugía electiva de pacientes del Hospital de Especialidades del Centro Médico Nacional Siglo XXI IMSS. Revista de la Sociedad Española del Dolor. 2011;18:91-97.

  5. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: a Clinical Practice Guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17:131-157.

  6. Santeularia M, Catalaga E, Genove M, Revuelta M, Moral M. Nuevas tendencias en el tratamiento del dolor posoperatorios en cirugía general digestiva. Cir Esp. 2009;86:63-71.

  7. Lee TH, Barrington MJ, Tran TM, Wong D, Hebbard PD. Comparison of extent of sensory block following posterior and subcostal approaches to ultrasound-guided transversus abdominis plane block. Anaesth Intensive Care. 2010;38:452-460.

  8. Owodunni OP, Zaman MH, Ighani M, Grant MC, Bettick D, Sateri S. Opioid tolerance impacts compliance with enhanced recovery pathway after major abdominal surgery. Surgery. 2019;166:1055-1060.

  9. Zaslansky R, Chapman R, Meissner W. ¿Qué se puede hacer para mejorar el manejo de dolor perioperatorio? Rev Mex Anestesiol. 2019;42:149-152.

  10. Onwochei DN, Borglum J, Pawa A. Abdominal wall blocks for intra-abdominal surgery. BJA Educ. 2018;18:317-322.

  11. Abdallah F, Laffety J, Halpern S, Brull R. Duration of analgesic effectiveness after the posterior and lateral transversum abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis. Br J Anaesth. 2013;111:721-735.

  12. Nair A, Amula VE, Naik V, Kodisharapu PK, Poornachand A, Shyam Prasad MS, et al. Comparison of postoperative analgesia in patients undergoing ileostomy closure with and without dual transversus abdominis plane (TAP) block: a randomized controlled trial. Rambam Maimonides Med J. 2019;10:e0004.

  13. Nguyen J. Post - Operative Pain Control. Elsevier. 2019;18:50-55.

  14. Viscusi ER, Gan TJ, Leslie JB, Foss JF, Talon MD, Du W, Owens G. Peripherally acting mu-opioid receptor antagonists and postoperative ileus: mechanisms of action and clinical applicability. Anesth Analg. 2009;108:1811-1822.

  15. Yiquan W, Fuli L, Hongli T, Quanguang W, Limei C, Hui W, et al. The analgesic efficacy of subcostal transversus abdominis plane block compared with thoracic epidural analgesia and intravenous opioid analgesia after radical gastrectomy. Anesth Analg. 2013;117:507-513.

  16. Mathew P, Aggarwal N, Kumari K, Gupta A, Panda N, Bagga R. Quality of recovery and analgesia after total abdominal hysterectomy under general anesthesia: A randomized controlled trial of TAP block vs epidural analgesia vs parenteral medications. J Anaesthesiol Clin Pharmacol. 2019;35:170-175.

  17. Ripolles J, Marmaña R, Abad A, Calvo J., Eficacia analgésica del bloqueo del plano transverso del abdomen ecoguiado-revisión sistemática. Braz J Anesthesiol. 2015;65:255-280.

  18. Warren JA, Carbonell AM, Jones LK, Mcguire A, Hand WR, Cancellaro VA, et al. Length of Stay and Opioid Dose Requirement with Transversus Abdominis Plane Block vs Epidural Analgesia for Ventral Hernia Repair. J Am Coll Surg. 2019;228:680-686.

  19. Turan A, Cohen B, Elsharkawy H, Maheshwari K, Soliman LM, Babazade R, et al. Transversus abdominis plane block with liposomal bupivacaine versus continuous epidural analgesia for major abdominal surgery: The EXPLANE randomized trial. J Clin Anesth. 2022;77:110640.

  20. Day AR, Smith RV, Scott MJ, Fawcett WJ, Rockall TA. Randomized clinical trial investigating the stress response from two different methods of analgesia after laparoscopic colorectal surgery. Br J Surg. 2015;102:1473-1479.

  21. Foo I, Macfarlane AJR, Srivastava D, Bhaskar A, Barker H, Knaggs R, et al. The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety. Anaesthesia. 2021;76:238e50.

  22. Shanthanna H, Weinberg G. Intravenous lidocaine, regional blockade, or both: considerations for multiple interventions involving local anaesthetics. Br J Anaesth. 2021;127:497-501.

  23. González A, Jiménez A, Rojas E, Velasco L, Chávez M, Coronado S. Correlación entre las escalas unidimensionales utilizadas en la medición de dolor postoperatorio. Rev Mex Anestesiol. 2018;41:7-14.

  24. Gravani S, Matiatou M, Nikolaidis PT, Menenakos E, Zografos CG, Zografos G, et al. Anxiety and Depression Affect Early Postoperative Pain Dimensions after Bariatric Surgery. J Clin Med. 2020;10:53.

  25. Waldhausen JH, Schirmer BD. The effect of ambulation on recovery from postoperative ileus. Ann Surg. 1990;212:671-677.




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