Impact of Ultrasound-Guided Transversus Abdominis Plane Block on Postoperative Pain and Early Outcome After Laparoscopic Bariatric Surgery: a Randomized Double-Blinded Controlled Trial
Based on the promising results of transversus abdominis plane (TAP) block in various abdominal procedures, this study aimed to investigate its effect on postoperative pain and early outcome after laparoscopic bariatric procedures.
Patients with morbid obesity were randomly assigned to one of two equal groups; group I had US-guided TAP block upon completion of the bariatric procedure and before recovery from general anesthesia and group II did not have TAP block. All procedures were performed laparoscopically with a standardized five-trocar technique.
Ninety-two patients of a mean age of 34.7 years and mean BMI of 49.5 kg/m2 were included. The mean pain score in group I was significantly lower than group II at 1 and 6 h postoperatively, whereas no significant differences in pains scores at 12 and 24 h between the two groups were observed. Eight patients in group I required rescue opioid analgesia within the first 24 h postoperatively, compared with 24 patients in group II (P < 0.0001). The postoperative nausea and vomiting (PONV) score at 24 h was significantly lower in group I than group II. Group I required a significantly shorter time to full ambulation and to pass flatus compared with group II. Hospital stay was similar in the two groups.
Using US-guided TAP block in adjunct with laparoscopic bariatric surgery managed to achieve lower pain scores, lower opioid requirements, lower PONV scores, earlier ambulation, shorter time to pass flatus, and comparable hospital stay and complication rate to the control group.
KeywordsBariatric surgery Postoperative pain Transversus abdominis plane, TAP block, ultrasound-guided
Sameh Emile and Khaled Elbahrawy designed the study. Khaled Elbahrawy performed the US-guided TAP block for patients and contributed to data analysis and revision of the manuscript. Sameh Emile, Mohamed Abdel-Razik, Ayman Elshobaky, Waleed Gado, and Hosam Elbanna performed the surgical procedures, followed the patients, and shared in data analysis and writing of the manuscript. Mostafa Shalaby and Samy Elbaz participated in patient follow-up, data interpretation, and drafting and critical revision of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Statement of Informed Consent
Informed consent was obtained from all individual participants included in the study.
Statement of Human and Animal Rights
This study was conducted in accordance with the declaration of Helsinki. Ethical approval for the study was obtained from the Institutional Review Board (IRB) of Mansoura Faculty of Medicine.
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