title: Postoperative analgesic effects of ultrasound-guided transversus abdominis plane block for open appendectomy.
abstract: OBJECTIVE
  Transversus abdominis plane (TAP) block is a newly developed and effective peripheral block involving the nerves of the anterior abdominal wall for lower abdominal surgery. We evaluated the postoperative analgesic efficacy of ultrasound-guided TAP block using 20 mL of 0.5% levobupivacaine in patients undergoing open appendectomy.
  
  
  METHODS
  Forty-four patients undergoing appendectomy were assigned either to undergo a right sided-TAP block (group I, n = 22), or to receive standard care (group II, n = 22). All patients received standard anesthetics, and the TAP block group received ultrasound-guided right side TAP block using 20 mL of 0.5% levobupivacaine after induction of anesthesia. All patients received acetaminophen, and nonsteroidal anti-inflammatory drug as required during the 48 postoperative hours. Each patients was assessed for time to first rescue analgesia, verbal numerical rating pain scores (VNRS), number of rescue analgesic demands, nausea, vomiting, pruritus, and drowsiness by a blinded investigator at 0, 1, 3, 6, 12, 24 and 48 hours postoperatively.
  
  
  RESULTS
  The TAP block group with levobupivacaine compared to the control group reduced VNRS significantly up to 12 hours postoperatively. There were no significant differences in time to first analgesia, number of rescue analgesics demands, nausea, vomiting, pruritus and drowsiness between the groups. There were no complications attributable to the TAP block.
  
  
  CONCLUSIONS
  Ultrasound-guided TAP block using 20 mL of 0.5% levobupivacaine provided effective postoperative analgesia during the 12 postoperative hours after an open appendectomy.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Sooyoung
authors.initials: S
authors.lastname: Cho
authors.forename: Youn-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dong-Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Soon-Sup
authors.initials: SS
authors.lastname: Chung
keywords: Appendectomy; Nerve block; Postoperative pain; Ultrasonography
references.citation: Anesth Analg. 2008 Dec;107(6):2056-60
references.pmid: 19020158
references.citation: Br J Anaesth. 2011 Jun;106(6):882-6
references.pmid: 21504934
references.citation: Anesth Analg. 2005 Nov;101(5 Suppl):S5-S22
references.pmid: 16334489
references.citation: Br J Anaesth. 2009 Nov;103(5):726-30
references.pmid: 19700776
references.citation: Br J Anaesth. 2009 Oct;103(4):601-5
references.pmid: 19561014
references.citation: Best Pract Res Clin Anaesthesiol. 2007 Mar;21(1):31-49
references.pmid: 17489218
references.citation: Anesth Analg. 2007 Jan;104(1):193-7
references.pmid: 17179269
references.citation: Paediatr Anaesth. 2008 Sep;18(9):891-2
references.pmid: 18768050
references.citation: Obes Surg. 2013 Apr;23(4):548-53
references.pmid: 23361468
references.citation: Anesth Analg. 1999 Sep;89(3):711-6
references.pmid: 10475311
references.citation: Korean J Anesthesiol. 2010 Apr;58(4):362-8
references.pmid: 20508793
references.citation: Anesth Analg. 2008 Jan;106(1):186-91, table of contents
references.pmid: 18165577
references.citation: Anesth Analg. 2011 Jun;112(6):1504-8
references.pmid: 21467560
references.citation: Reg Anesth Pain Med. 2012 Mar-Apr;37(2):188-92
references.pmid: 22330261
references.citation: Paediatr Anaesth. 2011 Oct;21(10):1078-80
references.pmid: 21981097