Gopwani S R, Rosenblatt M A
Department of Anesthesiology, MedStar Georgetown University Hospital, Washington, DC, USA.
Department of Anesthesiology, Mount Sinai St. Luke's and Roosevelt Hospitals, New York, NY, USA.
Saudi J Anaesth. 2016 Oct-Dec;10(4):375-378. doi: 10.4103/1658-354X.177326.
The efficacy of the transversus abdominis plane (TAP) block appears to vary considerably, depending on the surgical procedure and block technique.
This study aims to add to the existing literature and provide a more clear understanding of the TAP blocks role as a postoperative analgesic technique, specifically in renal allotransplant recipients.
A retrospective chart review was conducted by querying the intraoperative electronic medical record system of a 1200-bed tertiary academic hospital over a 5 months period, and reviewing anesthetic techniques, as well as postoperative morphine equivalent consumption.
Fifty renal allotransplant recipients were identified, 13 of whom received TAP blocks while 37 received no regional analgesic technique. All blocks were performed under ultrasound guidance, with 20 mL of 0.25% bupivacaine injected in the transversus abdominis fascial plane under direct visualization. The primary outcome was postoperative morphine equivalent consumption.
Morphine consumption was compared with the two-tailed Mann-Whitney -test. Continuous variables of patient baseline characteristics were analyzed with unpaired -test and categorical variables with Fischer Exact Test. A < 0.05 was considered statistically significant.
A statistically significant decrease in cumulative morphine consumption was found in the group that received the TAP block at 6 h (2.46 mg vs. 7.27 mg, = 0.0010), 12 h (3.88 mg vs. 10.20 mg, = 0.0005), 24 h (6.96 mg vs. 14.75 mg, = 0.0013), and 48 h (11 mg vs. 20.13 mg, = 0.0092).
The TAP block is a beneficial postoperative analgesic, opiate-sparing technique in renal allotransplant recipients.
腹横肌平面（TAP）阻滞的疗效似乎差异很大，这取决于手术方式和阻滞技术。
本研究旨在补充现有文献，并更清楚地了解TAP阻滞作为一种术后镇痛技术的作用，特别是在肾移植受者中。
通过查询一家拥有1200张床位的三级学术医院的术中电子病历系统，对5个月期间的麻醉技术以及术后吗啡等效剂量消耗情况进行回顾性图表审查。
确定了50例肾移植受者，其中13例接受了TAP阻滞，37例未接受区域镇痛技术。所有阻滞均在超声引导下进行，在直视下于腹横肌筋膜平面注射20ml 0.25%布比卡因。主要结局是术后吗啡等效剂量消耗。
吗啡消耗量采用双尾曼-惠特尼检验进行比较。患者基线特征的连续变量采用不成对检验分析，分类变量采用费舍尔精确检验分析。P<0.05被认为具有统计学意义。
接受TAP阻滞的组在6小时（2.46mg对7.27mg，P = 0.0010）、12小时（3.88mg对10.20mg，P = 0.0005）、24小时（6.96mg对14.75mg，P = 0.0013）和48小时（11mg对20.13mg，P = 0.0092）时累积吗啡消耗量有统计学意义的下降。
TAP阻滞是肾移植受者有益的术后镇痛、节省阿片类药物的技术。
