title: Laparoscopic-Assisted Transversus Abdominis Plane Block for Postoperative Pain Control in Laparoscopic Ventral Hernia Repair: A Randomized Controlled Trial.
abstract: BACKGROUND
  Laparoscopic ventral hernia repair (LVHR) is associated with considerable postoperative pain. Transversus abdominis plane (TAP) blocks have proven effective in controlling postoperative pain in a variety of laparoscopic abdominal operations. To date, no studies have focused on TAP blocks in LVHR. Our goal was to assess whether TAP blocks reduce opioid requirements and pain scores after LVHR.
  
  
  METHODS
  Patients undergoing LVHR were randomly assigned to receive a TAP block or placebo injection. The primary end points were cumulative opioid use at 1, 3, 6, 12, 18, and 24 hours postoperatively and pain scores recorded at 1 and 24 hours postoperatively.
  
  
  RESULTS
  Patients in the experimental TAP group (n = 52) and control group (n = 48) were comparable with respect to patient demographics and clinical characteristics. In the postanesthesia care unit, the TAP group had significantly lower pain scores than the control group (p < 0.05). Patients in the TAP group used less opioids than the control group at each time point assessed after 6 hours postoperatively (p < 0.05). There was no significant difference in pain scores at 24 hours postoperatively (p > 0.05).
  
  
  CONCLUSIONS
  Transversus abdominis plane blocks given during LVHR significantly decrease both short-term postoperative opioid use and pain experienced by patients.
authors.affiliation: Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Fields
authors.affiliation: Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Dani O
authors.initials: DO
authors.lastname: Gonzalez
authors.affiliation: Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Edward H
authors.initials: EH
authors.lastname: Chin
authors.affiliation: Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Scott Q
authors.initials: SQ
authors.lastname: Nguyen
authors.affiliation: Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Linda P
authors.initials: LP
authors.lastname: Zhang
authors.affiliation: Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Celia.Divino@mountsinai.org.
authors.forename: Celia M
authors.initials: CM
authors.lastname: Divino
mesh_terms: D000009:Abdominal Muscles / Q000294:innervation; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local; D002045:Bupivacaine; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine