Advertisement

Topics

Surgical Versus Ultrasound Guided TAP Block for Postoperative Analgesia After Midline Laparotomy.

2016-11-30 15:45:24 | BioPortfolio

Summary

Transversus abdominis plane (TAP) block is a novel type of peripheral nerve block that involves innervations of the anterolateral abdominal wall derived from T6-L1.It provides adequate post-operative pain relieve following the various abdominal surgeries. Theoretically, TAP block may replace the need for epidural analgesia after abdominal operations. The oblique subcostal approach of the TAP (OSTAP) block, which was de¬scribed by (Hebbard et al, 2010) , has been reported to provide analgesia to the entire anterior abdomen.

Description

The transversus abdominis plane (TAP) technique, originally described by (Rafi, 2001) involves injection of local anaesthetic in the plane between the internal oblique and transversus abdominis muscle layers, with the aim of anaesthetising the intercostal nerves supplying the abdominal wall. Initially, the block used surface landmarks of the triangle of Petit (latissimus dorsi posteriorly, external oblique superiorly, iliac crest inferiorly) and a double fascial 'pop' (loss of resistance) to guide placement of the local anaesthetic (Rafi, 2001) More recently, ultrasonography has been used to guide the delivery of the injectate into the appropriate plane, thereby increasing the accuracy of the technique (Bonnet et al, 2009, Carney et al ,2008, McDonnel et al,2008 ,Milan et al ,2011, Niraj et al, 2011). However, in some reports the safety of TAP blocks has been raised. . (Jankovic et al, 2008) There have also been reports of liver injury caused by needle damage.(Farooq et al,2008, Lancaster et al,2010) Theoretical concerns have also been discussed regarding the risk of femoral nerve palsy.( Walker et al , 2010, Rosario, et al 1997). Landmark techniques and utrasonography guided placement of TAP blocks may also be more difficult in obese patients needs experience and may be not available in certain areas.

Recently, surgically administered TAP blocks have been described, allowing a more accurate placement (Owen et al, 2014, Araco et al 2010, Bharti et al 2011).

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment

Conditions

Postoperative Pain

Intervention

Bupivacaine 0.25% 20ml on each side Sonar guided TAB, bupivacaine 0.25% 20ml on each side Surgical TAB, Ultrasound

Location

Hala Saad Abdel-Ghaffar
Asyut
Assiut governorate
Egypt
715715

Status

Recruiting

Source

Assiut University

Results (where available)

View Results

Links

Published on BioPortfolio: 2016-11-30T15:45:24-0500

Clinical Trials [784 Associated Clinical Trials listed on BioPortfolio]

LIA in Hip Arthroscopy Patients

The investigator's are conducting a randomized, blinded study to determine if the extra-capsular local infiltration analgesic (LIA) administration of 20ml 0.25% bupivacaine-epinephrine can...

EUS Guided Neurolysis Celiac Block w/wo Bupivacaine in Patient Being Treated Palliatively for Pancreatic Cancer

The goal of this project is to determine if EUS-CPN without Bupivacaine (versus EUS-CPN with Bupivacaine) can reduce pain scores and improve quality of life in patients with inoperable pan...

Bupivacaine Effectiveness and Safety in SABER™ Trial

This is a research study testing SABER™-Bupivacaine (an experimental pain-relieving medication). SABER™-Bupivacaine is designed to continuously deliver bupivacaine, a common local ane...

Dexmedetomidine and Bupivacaine With Bupivacaine in Ultrasonography Guided Fascia Iliaca Compartment Block in Adults

Few studies have reported the efficacy of adding dexmedetomidine to bupivacain for fascia illiaca compartment black. Comparison of dexmedetomidine and bupivacaine with bupivacaine alone on...

A Comparison of Exparel Local Anesthetic in Total Knee Arthroplasty (TKA) Patients

This is a prospective, single-center, single-blinded, randomized, case-control study. The study is conducted by a single investigator at an orthopedic surgery institute, with a minimum 6 w...

PubMed Articles [4203 Associated PubMed Articles listed on BioPortfolio]

Liposomal bupivacaine versus bupivacaine/epinephrine after video-assisted thoracoscopic wedge resection†.

The purpose of this research is to compare liposomal bupivacaine and bupivacaine/epinephrine for intercostal blocks related to analgesic use and length of stay following video-assisted thoracoscopic w...

Comparison of peri-articular liposomal bupivacaine and standard bupivacaine for postsurgical analgesia in total knee arthroplasty: a systematic review and meta-analysis.

This meta-analysis aimed to compare the efficacy and safety of intraoperative peri-articular liposomal bupivacaine and standard bupivacaine in patients undergoing total knee arthroplasty.

Intraspinal administration of morphine hydrochloride combined with low doses of bupivacaine in hemorrhoidectomy: a clinical randomised trial.

Intrathecal local anesthetics, associated or not to opioids, is commonplace in anorectal surgery, but it is unknown which is the option with the best risk-benefit ratio. The main aim was to assess whe...

Efficacy of Liposomal Bupivacaine Infiltration on the Management of Total Knee Arthroplasty.

Liposomal bupivacaine is a novel extended-duration anesthetic that has recently been used for local infiltration in total knee arthroplasty (TKA). Athough liposomal bupivacaine is widely used, it is u...

Liposomal bupivacaine infiltration at the surgical site for the management of postoperative pain.

Despite multi-modal analgesic techniques, acute postoperative pain remains an unmet health need, with up to three quarters of people undergoing surgery reporting significant pain. Liposomal bupivacain...

Medical and Biotech [MESH] Definitions

A widely used local anesthetic agent.

A local anesthetic with rapid onset and long action, similar to BUPIVACAINE.

A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine.

A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)

Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.

More From BioPortfolio on "Surgical Versus Ultrasound Guided TAP Block for Postoperative Analgesia After Midline Laparotomy."

Quick Search
Advertisement
 

Searches Linking to this Trial