Two-stage laparoscopic transversus abdominis plane block as an equivalent alternative to thoracic epidural anaesthesia in bowel resection : an explorative cohort study / M. Kaufmann, V. Orth, T.-J. Dorwarth, J. Benrath, B. Gerber, D. Ghezel-Ahmadi, C. Reißfelder, F. Herrle

Purpose: We evaluated the effect of the two-stage laparoscopic transversus abdominis plane block (TS-L-TAPB) in comparison to thoracic epidural anaesthesia (TEA) and a one-stage L-TAPB (OS-L-TAPB) in patients who underwent elective laparoscopic bowel resection. Methods: We compared a TS-L-TAPB (266 mg bupivacaine), which was performed bilaterally at the beginning and end of surgery, with two retrospective cohorts. These were patients who had undergone a TEA (ropivacaine/sufentanil) or an OS-L-TAPB (200 mg ropivacaine) at the beginning of surgery. Oral and i.v. opiate requirements were documented over the first 3 postoperative days (POD). Results: Patients were divided into three groups TEA (n = 23), OS-L-TAPB (n = 75), and TS-L-TAPB (n = 49). By the evening of the third POD, patients with a TEA had a higher cumulative opiate requirement with a median of 45.625 mg [0; 202.5] than patients in the OS-L-TAPB group at 10 mg [0; 245.625] and the TS-L-TAPB group at 5.625 mg [0; 215.625] (p = 0.1438). One hour after arrival in the recovery room, significantly more patients in the TEA group (100%) did not need oral and i.v. opioids than in the TS-L-TAPB (78%) and OS-L-TAPB groups (68%) (p = 0.0067).This was without clinical relevance however as the median in all groups was 0 mg. On the third POD, patients in the TEA group had a significantly higher median oral and i.v. opioid dose at 40 mg [0; 80] than the TS-L-TAPB and OS-L-TAPB groups, both at 0 mg [0; 80] (p = 0.0009). Conclusion: The TS-L-TAP showed statistically significant and clinically meaningful benefits over TEA and OS-L-TAP in reducing postoperative opiate requirements..

Medienart:

E-Artikel

Erscheinungsjahr:

11 January 2024

2024

Erschienen:

11 January 2024

Enthalten in:

Zur Gesamtaufnahme - volume:39

Enthalten in:

International journal of colorectal disease - 39(2024), Artikel-ID 18, Seite 1-8

Sprache:

Englisch

Beteiligte Personen:

Kaufmann, Mario, 1998- [VerfasserIn]
Orth, Vanessa [VerfasserIn]
Dorwarth, Tim-Janick, 1996- [VerfasserIn]
Benrath, Justus, 1968- [VerfasserIn]
Gerber, Benjamin, 1988- [VerfasserIn]
Ghezel-Ahmadi, D. [VerfasserIn]
Reißfelder, Christoph, 1975- [VerfasserIn]
Herrle, Florian, 1972- [VerfasserIn]

Links:

Volltext [kostenfrei]

Themen:

Bowel resection
L-TAP
TAP
Thoracic epidural anaesthesia
Two-stage laparoscopic transversus abdominis plane block

Anmerkungen:

Gesehen am 16.02.2024

Umfang:

Illustrationen

8

doi:

10.1007/s00384-023-04592-6

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

1881030911

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