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Ultrasound-Guided Bilateral Transversus Abdominis Plane (US-TAP) Block for Postoperative Analgesia After Breast Reconstruction by Deep Intra Epigastric Perforator (DIEP) Flap

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Abstract

Autologous breast reconstruction by deep inferior epigastric perforator (DIEP) flap provides higher postoperative pain at the abdominal donor site than at the thoracic one. The authors evaluated the analgesic efficacy of ultrasound-guided transverse abdominis plane block for postoperative analgesia after immediate breast reconstruction by DIEP flap through an open prospective study of 30 consecutive women undergoing immediate DIEP flap breast reconstruction after modified radical mastectomy for cancer. The last 15 patients received a bilateral ultrasound-guided block with 1.5 mg/kg ropivacaine on each side after DIEP flap harvesting, under general anesthesia. All patients received postoperative acetaminophen and patient-controlled intravenous morphine and were assessed for morphine use, satisfaction with pain relief, and adverse effects. Morphine requirements were significantly lower in the block group than in the control group. Bilateral ultrasound-guided transversus abdominis plane block after breast reconstruction by DIEP flap reduces the interval and cumulative morphine requirements for the first 24 and 48 h, respectively.

The first two authors contributed equally to the article and should be considered co lead authors.

This study was self-funded by the Plastic Surgery Department and the Department of Anesthesiology and Intensive Care, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris.

This work had been published in Hivelin M, Wyniecki A, Plaud B, Marty J, Lantieri L. Ultrasound-guided bilateral transversus abdominis plane block for postoperative analgesia after breast reconstruction by DIEP flap. Plast Reconstr Surg. 2011 Jul;128(1):44-55. doi: 10.1097/PRS.0b013e3182174090. Copyright authorization from Wolters Kluwer Health for Plastic and Reconstructive Surgery to Springer.

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Acknowledgments

The authors thank the Postoperative Care Unit, the Anesthesiology and Plastic Surgery departments, and particularly Drs. Catherine Liger, Valérie Brun Buisson, Elisabeth Faucheux, Véronique François, Chaker Benhamida, and the operating room manager, Philippe Sanvoisin, for their invaluable help and patience.

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Authors and Affiliations

  1. Department of de Chirurgie Plastique Reconstructrice et Esthétique, Hôpital Europeen Georges Pompidou, Université Paris Descartes, 20, rue Leblanc, Paris, 75015, France

    Mikaël Hivelin M.D., Ph.D. & Laurent Lantieri M.D.

  2. Anesthesiology and Reanimation, Gustave Roussy Cancer Campus, Villejuif, France

    Anne Wyniecki M.D.

  3. Anesthesiology and Reanimation, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Paris Diderot, Paris, France

    Benoit Plaud M.D., Ph.D.

  4. Anesthesiology and Reanimation, Samu94-Smur, GHU A Chenevier H Mondor Université (PRES), Paris Est Créteil, France

    Jean Marty M.D., Ph.D.

Authors
  1. Mikaël Hivelin M.D., Ph.D.
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  2. Anne Wyniecki M.D.
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  3. Benoit Plaud M.D., Ph.D.
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  4. Jean Marty M.D., Ph.D.
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  5. Laurent Lantieri M.D.
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Corresponding author

Correspondence to Mikaël Hivelin M.D., Ph.D. .

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Editors and Affiliations

  1. Tustin, California, USA

    Melvin A. Shiffman

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Hivelin, M., Wyniecki, A., Plaud, B., Marty, J., Lantieri, L. (2016). Ultrasound-Guided Bilateral Transversus Abdominis Plane (US-TAP) Block for Postoperative Analgesia After Breast Reconstruction by Deep Intra Epigastric Perforator (DIEP) Flap. In: Shiffman, M. (eds) Breast Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-18726-6_107

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  • DOI: https://doi.org/10.1007/978-3-319-18726-6_107

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18725-9

  • Online ISBN: 978-3-319-18726-6

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