title: Four quadrant transversus abdominis plane block and continuous transversus abdominis plane analgesia: a 3-year prospective audit in 124 patients.
abstract: OBJECTIVE
  Transversus abdominis plane (TAP) blocks have been reported to be an effective method of providing analgesia after abdominal surgery. To perform a prospective audit on the effectiveness of a novel technique of providing continuous transversus abdominis plane (TAP) analgesia in patients undergoing emergency and elective abdominal surgery.
  
  
  METHODS
  Prospective single center audit over a 3-year period.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred twenty-four American Society of Anesthesiologists I to IV adult patients presenting for elective as well as emergency abdominal surgery in whom epidural analgesia was contraindicated or refused.
  
  
  METHODS
  Four quadrant TAP blocks and continuous TAP analgesia.
  
  
  METHODS
  Numerical rating scale pain scores at rest and on coughing, nausea scores, satisfaction scores, complications, frequency of analgesia failure, therapeutic failure with continuous TAP analgesia and opioid consumption.
  
  
  RESULTS
  One hundred twenty-four patients who received continuous TAP analgesia were audited. This included 34 patients for elective open surgery, 36 patients for emergency laparotomy, and 54 patients who underwent elective laparoscopic colorectal surgery. Surgical incision was within the dermatomal limit of the block in 70% of the patients (88/124). Therapeutic failure with the technique was 10%. Frequency of analgesic failure over the 48-hour period was none in 39% and below 5 episodes in 57%.
  
  
  CONCLUSIONS
  Four quadrant transversus abdominis plane blocks and continuous TAP analgesia is an effective technique for providing postoperative analgesia after abdominal surgery. It has the potential to be used as a sole analgesic technique when the surgical incision is within its dermatomal limit.
authors: Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. Electronic address: nirajgopinath@yahoo.co.uk.
authors: G
authors: G
authors: Niraj
authors: Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors: Aditi
authors: A
authors: Kelkar
authors: Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors: Elaine
authors: E
authors: Hart
authors: Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors: Vipul
authors: V
authors: Kaushik
authors: Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors: Danny
authors: D
authors: Fleet
authors: Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors: John
authors: J
authors: Jameson
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000009:Abdominal Muscles; D000328:Adult; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid
keywords: Continuous TAP analgesia; Four quadrant TAP analgesia