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Effects of preoperative ultrasound-guided transversus abdominis plane block on pain after laparoscopic surgery for colorectal cancer: a double-blind randomized controlled trial

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Abstract

Background

Although laparoscopic colorectal surgery decreases postoperative pain and facilitates a speedier recovery compared with laparotomy, postoperative pain at trocar insertion sites remains a clinical concern. The objective of this study was to assess the effects of a preoperative ultrasound-guided transversus abdominis plane (TAP) block on pain after laparoscopic surgery for colorectal cancer.

Methods

In total, 58 patients scheduled to undergo laparoscopic surgery following a diagnosis of colorectal cancer were included in this study. The patients were randomized into TAP and control groups; the TAP group patients received a preoperative ultrasound-guided bilateral TAP block with 0.5 mL/kg of 0.25 % bupivacaine, while the control patients received the block with an equal amount of saline. Pain on coughing and at rest was assessed during postanesthetic recovery (PAR; 1 h after surgery) and on postoperative days (PODs) 1 (24 h), 2 (48 h), and 3 (72 h) by an investigator blinded to group allocations using the numeric rating scale (NRS). The primary outcome was pain on coughing on postoperative day (POD) 1.

Results

Fifty-five patients were included in the final analysis, including 28 in the TAP and 27 in the control groups. The pain intensity on coughing and at rest during PAR and on PODs 1, 2, and 3 showed no significant differences between groups. Furthermore, there was no significant difference in postoperative opioid consumption, sedation scores, nausea scores at the four time points, complication rates, and length of hospital stay between groups.

Conclusions

In colorectal cancer patients undergoing laparoscopic colorectal surgery, a TAP block did not offer enough benefit for clinical efficacy in terms of postoperative pain or analgesic consumption.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea

    Tak Kyu Oh, Jaehyun Kim, Woosik Eom, Soon Ae Lee & Dae Hyun Kim

  2. Moonsan Central General Hospital, Paju, Republic of Korea

    Jiyeon Yim

  3. Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea

    Sung Chan Park & Jae Hwan Oh

  4. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Ji Won Park

  5. Biometric Research Branch, Research Institute and Hospital, National Cancer Centre, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea

    Boram Park

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  1. Tak Kyu Oh
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  2. Jiyeon Yim
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  5. Soon Ae Lee
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  7. Jae Hwan Oh
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  10. Dae Hyun Kim
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Correspondence to Dae Hyun Kim.

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Disclosures

Drs. Tak Kyu Oh, Jiyeon Yim, Jaehyun Kim, Woosik Eom, Soon Ae Lee, Sung Chan Park, Jae Hwan Oh, Jiwon Park, Boram Park, and Dae Hyun Kim have no conflict of interests or financial ties to disclose.

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Dae Hyun Kim is the archival author.

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Oh, T.K., Yim, J., Kim, J. et al. Effects of preoperative ultrasound-guided transversus abdominis plane block on pain after laparoscopic surgery for colorectal cancer: a double-blind randomized controlled trial. Surg Endosc 31, 127–134 (2017). https://doi.org/10.1007/s00464-016-4941-7

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  • DOI: https://doi.org/10.1007/s00464-016-4941-7

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