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Efficacy of laparoscopic transversus abdominis plane block on postoperative pain management and surgery side effects in laparoscopic bariatric surgeries

  • Controlled Clinical Trials
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Abstract

Purpose

Transversus abdominis plane (TAP) block is a new option for reducing postoperative pain. This study investigated the effects of laparoscopic TAP block on postoperative adverse events and analgesia and antiemetics requirements after bariatric surgery.

Methods

In this randomized clinical trial study, patients were randomly divided into control (N = 20) or TAP block (N = 20) groups. In the TAP block group, the block was performed under direct laparoscopic guidance after surgery and before the removal of trocars.

Results

Fifteen patients (75%) versus four patients (20%) received opioids within the first 6 h in the control and TAP groups, respectively (p-value < 0.001). The cumulative amount of opioids consumed in the 24 and 48 h after surgery was lower in the TAP group (p-value < 0.001). The visual analog scale (VAS) regarding general and wound-specific pain was significantly lower in the TAP group compared to the control group at 6 and 24 h both at rest and in movement. However, there was no significant difference at 48 h postoperatively. The percentages of patients having postoperative nausea and vomiting (PONV), pruritus, and resumption of bowel movement were not significantly different between the two groups at any time (6, 24, and 48 h) postoperatively.

Conclusion

Laparoscopic-guided TAP block is a pragmatic, applicable, and minimally invasive regional technique and can be part of effective postoperative pain management in morbidly obese patients undergoing bariatric surgery. Applying it laparoscopically without the need for ultrasound is also useful and effective.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Author information

Authors and Affiliations

  1. Department of Surgery, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Sayed Mehdi Jalali

  2. Department of Surgery, Shahid Madani Hospital, Faculty of Medicine, Alborz University of Medical Sciences, Alborz, Iran

    Mohammad Hadi Bahri

  3. Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Seyed Mostafa Meshkati Yazd, Mohamadreza Karoobi & Niloufar Shababi

Authors
  1. Sayed Mehdi Jalali
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  2. Mohammad Hadi Bahri
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Contributions

Sayed Mehdi Jalali: conceptualization, methodology, and project administration; Mohammad Hadi Bahri: formal analysis, data curation, investigation, and writing—original draft; Seyed mostafa meshkati yazd: methodology, critical revision, and data analysis; Mohamadreza Karoobi: data gathering, writing—review and editing, and final approval of the version to be published; Niloufar Shababi: methodology, critical revision, and data analysis.

Corresponding author

Correspondence to Mohammad Hadi Bahri.

Ethics declarations

Ethics approval

The study was approved by the Ethics Committee of the Tehran University of Medical Sciences. Permission to carry out the study and access patient records was sought from the respective university administrators. Code: IR.TUMS.IKHC.REC.1396.3867.

Consent to participate

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

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Key points

• The amount of opioids administered after surgery was lower in the TAP group.

• VAS scores were significantly lower in the TAP group at 6 and 24 h after surgery.

• TAP block can be beneficial for postoperative pain management in bariatric surgeries.

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Cite this article

Jalali, S.M., Bahri, M.H., Yazd, S.M.M. et al. Efficacy of laparoscopic transversus abdominis plane block on postoperative pain management and surgery side effects in laparoscopic bariatric surgeries. Langenbecks Arch Surg 407, 549–557 (2022). https://doi.org/10.1007/s00423-021-02400-9

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  • DOI: https://doi.org/10.1007/s00423-021-02400-9

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