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Continuous Transversus Abdominis Plane Blocks via Laparoscopically Placed Catheters for Bariatric Surgery

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Abstract

Objectives

The objective of the present study is to evaluate postoperative analgesic outcome of the continuous bilateral transversus abdominis plane (TAP) block using bupivacaine infusion through an epidural catheter inserted through laparoscopic ports.

Patients and Methods

Ninety patients assigned for laparoscopic sleeve gastrectomy (LSG) were divided into two equal groups according to postoperative analgesia: Control group received IV morphine, and TAP group received bupivacaine 0.25% continuous infusion TAP block through epidural catheters introduced through laparoscopic ports, grasped, and inserted in laparoscopically prepared TAP. Catheters were removed 24 h postoperatively. Frequency and severity of postoperative pain were assessed using numeric rating scale (NRS). Cumulative pain score, number of requests, and total dose of administered rescue analgesia were recorded.

Results

Pain scores were significantly lower throughout 24 h postoperative with a significantly lower cumulative score in the TAP group compared to the control group. Twenty-four patients in the TAP group did not require rescue analgesia, and 17 patients required it once with a significantly higher frequency of patients having a higher number of rescue analgesia requests in the control group. The mean of number of patients requested rescue analgesia; the number of requested doses and total dose of morphine received was significantly lower in the TAP group. Mean time till first ambulation and oral intake was significantly shorter, and morphine-related side effects were significantly lower in the TAP group. Total and differential satisfaction scores were significantly higher in the TAP group.

Conclusion

Continuous bupivacaine TAP block provided through an epidural catheter passed through laparoscopic ports improved postoperative outcome of LSG in terms of reduced postoperative pain scores, sparing morphine consumption, and early recovery items.

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Authors and Affiliations

  1. Department of Anesthesiology, Ain Shams University, Cairo, Egypt

    Alfred M. Said

  2. Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt

    Hany A. Balamoun

Authors
  1. Alfred M. Said
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  2. Hany A. Balamoun
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Corresponding author

Correspondence to Hany A. Balamoun.

Ethics declarations

The study protocol was approved by the local ethical committee.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Said, A.M., Balamoun, H.A. Continuous Transversus Abdominis Plane Blocks via Laparoscopically Placed Catheters for Bariatric Surgery. OBES SURG 27, 2575–2582 (2017). https://doi.org/10.1007/s11695-017-2667-9

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  • DOI: https://doi.org/10.1007/s11695-017-2667-9

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