title: Transversus abdominis plane block reduces the analgesic requirements after abdominoplasty with flank liposuction.
abstract: BACKGROUND
  The transversus abdominis plane (TAP) block is a technique of locoregional anesthesia that blocks the sensorial afferent nerves localized between the transversus abdominis muscle and the internal oblique muscle. We describe results obtained with a case control study between patients undergoing abdominoplasty with the TAP block compared with a similar group of patients not receiving the block.
  
  
  METHODS
  Medical notes were reviewed, and patients were classified according to the presence of TAP. Outcomes evaluated were the requirements of morphine in the first postoperative hour and the number of co-codamol tablets administered afterward.
  
  
  RESULTS
  Seventy-five patients were screened. No intra- or postoperative complications were recorded. TAP+ patients required significantly less analgesia during the first 12 postoperative hours (P < 0.001). The patients with increased body mass index and large flap resected were more likely to fail the anesthetic block and required postoperative analgesia.
  
  
  CONCLUSIONS
  In aesthetic abdominal surgery, the TAP block is safe, is performed without ultrasound guidance, and markedly reduces the requirement of postoperative opioid analgesia. Future studies will now confirm these results and evaluate the consequences in terms of postoperative nausea, vomiting, and overall satisfaction of patients.
authors.affiliation: Dolan Park Hospital, Bromsgrove, Birmingham, United Kingdom.
authors.forename: Antonino
authors.initials: A
authors.lastname: Araco
authors.forename: Jack
authors.initials: J
authors.lastname: Pooney
authors.forename: Francesco
authors.initials: F
authors.lastname: Araco
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gravante
mesh_terms: D050153:Abdominal Fat / Q000601:surgery; D000009:Abdominal Muscles / Q000294:innervation / Q000601:surgery*; D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D002045:Bupivacaine / Q000494:pharmacology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D009020:Morphine / Q000494:pharmacology; D019148:Neuromuscular Blockade / Q000379:methods*; D009765:Obesity / Q000175:diagnosis / Q000601:surgery*; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D012016:Reference Values; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D009020:Morphine; D002045:Bupivacaine