title: Ultrasound/Laparoscopic Camera-Guided Transversus Abdominis Plane Block for Renal Transplant Donors: A Randomized Controlled Trial.
abstract: BACKGROUND
  The most common treatment modality for postoperative pain relief following laparoscopic surgery is multimodal, using nonsteroidal antiinflammatory drugs (NSAID), opioids, and infiltration of local anesthetics. Because NSAIDs are nephrotoxic, local infiltration does not relieve deep tissue pain, and opioids have an adverse effects profile including pruritus, nausea, vomiting, oversedation, apnea, and decreased gastrointestinal motility. Therefore, the use of a regional analgesic technique can lead to an improved quality of recovery. The aim of this prospective, randomized, placebo-controlled study was to evaluate the effect of TAP block on postoperative verbal analog scale (VAS) scores and total morphine requirements in the first 24 hours after laparoscopic live donor nephrectomy.
  
  
  METHODS
  After obtaining approval from the hospital ethics committee and written informed consent from the patients, 49 ASA I-II patients undergoing laparoscopic donor nephrectomy, aged 18 years or over, were included in this prospective, randomized, controlled study. In this clinical trial patients were divided into 2 groups: TAP block group (group T) and placebo group (group P). The demographic variables, pain scores, morphine consumption, level of sedation, presence of postoperative nausea, vomiting, pruritus, and average length of postoperative stay were reviewed.
  
  
  RESULTS
  The pain scores were significantly lower after TAP block with bupivacaine at most but not all time points. Patients receiving the TAP block with bupivacaine required less morphine up to 24 hours after surgery compared with the saline group.
  
  
  CONCLUSIONS
  USG-guided TAP block as part of a balanced analgesia regimen is of benefit in reducing postoperative pain and morphine consumption after laparoscopic donor nephrectomy.
authors.affiliation: Department of Anesthesiology and Reanimation, Acibadem University, Acibadem International Hospital, İstanbul, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Güner Can
authors.affiliation: Department of Anesthesiology and Reanimation, Acibadem University, Acibadem International Hospital, İstanbul, Turkey.
authors.forename: Rüya
authors.initials: R
authors.lastname: Göz
authors.affiliation: Department of Transplantation Center, Acibadem University, Acibadem International Hospital, İstanbul, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Berber
authors.affiliation: Department of Medical Informatics, Yeditepe University, İstanbul, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Kaspar
authors.affiliation: Department of Nephrology, Acibadem University, Acibadem International Hospital, İstanbul, Turkey.
authors.forename: Ülkem
authors.initials: Ü
authors.lastname: Çakır
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D009294:Narcotics; D009020:Morphine; D002045:Bupivacaine