Efficacy of transversus abdominis plane blocks in laparoscopic colorectal resections.
BACKGROUND
The increasing use of laparoscopic techniques for colorectal resections means that the issue of postoperative analgesia needs to be reassessed. This nonrandomized comparative study aimed to assess the efficacy of the transversus abdominis plane (TAP) block in laparoscopic colorectal resections.


METHODS
Prospectively collected data from consecutive patients undergoing laparoscopic colorectal resections were used. Analgesia usage and outcome data for patients who had a TAP block and a postoperative morphine patient-controlled analgesia pump (PCA) were compared with those for patients who had a PCA alone.


RESULTS
Data for 74 patients were used in the final analysis (40 TAP/PCA and 34 PCA alone). There was a significant reduction in overall intravenous opiate use in the TAP/PCA group (31.3 vs. 51.8 mg; P = 0.03). The TAP/PCA group showed a slight trend toward a shorter hospital stay (3 vs. 4 days; P = 0.17) but no difference in postoperative complications or any other outcome measure. There was no procedure-related morbidity relating to the use of TAP blocks.


CONCLUSIONS
It appears that TAP blocks reduce postoperative analgesia use of patients undergoing laparoscopic colorectal resections within an enhanced recovery program, and this may have an impact on their postoperative hospital length of stay.
Conaghan
Philip
P
Department of Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK. conaghan@doctors.org.uk
Maxwell-Armstrong
Charles
C
Bedforth
Nigel
N
Gornall
Chris
C
Baxendale
Bryn
B
Hong
Li-Lin
LL
Carty
Hyun-Mi
HM
Acheson
Austin G
AG
D034861:Abdominal Wall / Q000000981:diagnostic imaging / Q000294:innervation; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D003082:Colectomy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D012007:Rectum / Q000601:surgery*; D014463:Ultrasonography
D000701:Analgesics, Opioid; D009020:Morphine