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2. A randomised controlled trial investigating the analgesic efficacy of transversus abdominis plane block for adult laparoscopic appendicectomy

Author

Shahridan Mohd Fathil, Darell Alexander Tupper-Carey, Pryseley Nkouibert Assam, Yin Kiat Glenn Tan, Fahad Javaid Siddiqui, Yuk Man Kan, and Chern Yuen Cheong

Subjects
Adult, Male, medicine.medical_specialty, Nausea, Analgesic, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, 030202 anesthesiology, Transversus Abdominis Plane Block, law, medicine, Appendectomy, Humans, General anaesthesia, 030212 general & internal medicine, Abdominal Muscles, Pain, Postoperative, Morphine, business.industry, Analgesia, Patient-Controlled, Nerve Block, General Medicine, Surgery, Clinical trial, Anesthesia, Vomiting, Original Article, Female, Laparoscopy, medicine.symptom, business, medicine.drug
Abstract

Introduction We conducted a single-centre, prospective randomised clinical trial to investigate the analgesic efficacy of transversus abdominis plane (TAP) block in adult patients undergoing laparoscopic appendicectomy. Methods Patients undergoing urgent laparoscopic appendicectomy under general anaesthesia alone (control group) and general anaesthesia supplemented by TAP block (TAP intervention group) were compared. All patients received a multimodal analgesia regime, which included postoperative morphine via a patient-controlled analgesia device. The primary endpoints were morphine consumption at 12 hours and 24 hours postoperatively. Secondary endpoints included pain scores, incidence of nausea and vomiting, and time to hospital discharge. A total of 58 patients were recruited, with 29 patients in each group. Results Mean postoperative morphine consumption at 12 hours (control group: 11.45 ± 7.64 mg, TAP intervention group: 9.79 ± 8.09 mg; p = 0.4264) and 24 hours (control group: 13.38 ± 8.72 mg, TAP intervention group: 11.31 ± 8.66 mg; p = 0.3686) for the control and TAP intervention groups were not statistically different. Secondary outcomes were also not different between the two groups. Length of stay in the post-anaesthesia care unit was significantly shorter for the TAP intervention group, with a trend toward faster hospital discharge being observed. Conclusion TAP block, a regional anaesthetic procedure performed immediately prior to skin incision for laparoscopic appendicectomy, did not significantly improve postoperative analgesia outcomes.

Published
2017

3. A randomised controlled trial investigating the analgesic efficacy of transversus abdominis plane block for adult laparoscopic appendicectomy.

Author

Tupper-Carey, Darell Alexander, Fathil, Shahridan Mohd, Yin Kiat Glenn Tan, Yuk Man Kan, Chern Yuen Cheong, Siddiqui, Fahad Javaid, Assam, Pryseley Nkouibert, Tan, Yin Kiat Glenn, Kan, Yuk Man, and Cheong, Chern Yuen

Subjects
APPENDIX surgery, GENERAL anesthesia, LAPAROSCOPIC surgery, SURGICAL complications, NAUSEA, VOMITING, POSTOPERATIVE pain prevention, DRUG therapy, ABDOMINAL muscles, APPENDECTOMY, COMPARATIVE studies, LAPAROSCOPY, RESEARCH methodology, MEDICAL cooperation, MORPHINE, NERVE block, PATIENT-controlled analgesia, RESEARCH, EVALUATION research, RANDOMIZED controlled trials, INNERVATION
Abstract

Introduction: We conducted a single-centre, prospective randomised clinical trial to investigate the analgesic efficacy of transversus abdominis plane (TAP) block in adult patients undergoing laparoscopic appendicectomy.Methods: Patients undergoing urgent laparoscopic appendicectomy under general anaesthesia alone (control group) and general anaesthesia supplemented by TAP block (TAP intervention group) were compared. All patients received a multimodal analgesia regime, which included postoperative morphine via a patient-controlled analgesia device. The primary endpoints were morphine consumption at 12 hours and 24 hours postoperatively. Secondary endpoints included pain scores, incidence of nausea and vomiting, and time to hospital discharge. A total of 58 patients were recruited, with 29 patients in each group.Results: Mean postoperative morphine consumption at 12 hours (control group: 11.45 ± 7.64 mg, TAP intervention group: 9.79 ± 8.09 mg; p = 0.4264) and 24 hours (control group: 13.38 ± 8.72 mg, TAP intervention group: 11.31 ± 8.66 mg; p = 0.3686) for the control and TAP intervention groups were not statistically different. Secondary outcomes were also not different between the two groups. Length of stay in the post-anaesthesia care unit was significantly shorter for the TAP intervention group, with a trend toward faster hospital discharge being observed.Conclusion: TAP block, a regional anaesthetic procedure performed immediately prior to skin incision for laparoscopic appendicectomy, did not significantly improve postoperative analgesia outcomes. [ABSTRACT FROM AUTHOR]

Published
2017
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