title: Local wound infiltration plus transversus abdominis plane (TAP) block versus local wound infiltration in laparoscopic colorectal surgery and ERAS program.
abstract: Few data are available on TAP block in laparoscopic colorectal surgery and ERAS program. The aim of this prospective study was to evaluate local wound infiltration plus TAP block compared to local wound infiltration in the management of postoperative pain, nausea and vomiting, ileus and use of opioids in the context of laparoscopic colorectal surgery and ERAS program.
  
  
  
  From March 2014 to March 2015, 48 patients were treated by laparoscopic resection and ERAS program for colorectal cancer and diverticular disease at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust. Among these, 24 patients received local wound infiltration plus TAP block (TAP block group) and 24 patients received local wound infiltration (control group).
  
  
  
  No differences were observed in baseline patient characteristics, clinical variables and surgical procedures between the two groups. Local wound infiltration plus TAP block allowed to achieve pain control despite a reduced use of opioid analgesics (P = 0.009). The adoption of TAP block resulted beneficial on the prevention of postoperative nausea (P = 0.002) and improvement of essential outcomes of ERAS program as recovery of bowel function (P = 0.005), urinary catheter removal (P = 0.003) and capability to tolerate oral diet (P = 0.027).
  
  
  
  TAP block plus local wound infiltration in the setting of laparoscopic colorectal surgery and ERAS program guarantees a reduced use of opioid analgesics and good pain control allowing the improvement of essential items of enhanced recovery pathways.
authors.affiliation: Division of General and Hepatobiliary Surgery, Department of Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy. corrado.pedrazzani@univr.it.
authors.forename: Corrado
authors.initials: C
authors.lastname: Pedrazzani
authors.affiliation: Division of Anesthesiology, Department of Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Menestrina
authors.affiliation: Division of General and Hepatobiliary Surgery, Department of Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Moro
authors.affiliation: Division of Anesthesiology, Department of Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Brazzo
authors.affiliation: Division of General and Hepatobiliary Surgery, Department of Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Mantovani
authors.affiliation: Division of Anesthesiology, Department of Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Polati
authors.affiliation: Division of General and Hepatobiliary Surgery, Department of Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guglielmi
mesh_terms: D000009:Abdominal Muscles / Q000294:innervation; D000732:Androstanols / Q000008:administration & dosage; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003082:Colectomy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D010149:Postoperative Pain / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D000077123:Rocuronium
chemical_list: D000732:Androstanols; D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium
keywords: Colorectal surgery; Enhanced recovery program; Laparoscopy; TAP block