Highlights
- •Mean pain scores were lower with bupivacaine and bupivacaine + epinephrine when compared to placebo.
- •There was a statistically significant difference in pain scores at 3 h post-operatively: for placebo.
- •There was no statistically significant difference in time to move on-feet, length of hospital stay (LOS), time to get back to work between the three groups.
- •There was no statistically significant difference in amount of nausea/vomiting medication given between the three groups.
- •There was no statistically significant difference in the total dosage of acetaminophen, gabapentin, opioid, and any other additional analgesic medication during the hospital stay between the three groups.
Abstract
Background
The aim of this randomized controlled trial was to assess the effectiveness of transversus
abdominis plane (TAP) block in post-operative pain management in patients undergoing
laparoscopic sleeve gastrectomy (LSG).
Methods
Ninety consecutive patients undergoing LSG were randomly assigned to three groups:
placebo, TAP block with 0.25% bupivacaine (40mL total), and TAP block with 0.25% bupivacaine +
1/100,000 epinephrine (40mL total). Pain and nausea/vomiting scores were evaluated
at varying times until discharge. Other parameters included, additional analgesia
required, time to ambulation, length of stay and time required for return to work
after discharge.
Results
There was decrease in post-operative pain 3 hours after surgery between the placebo
group and the bupivacaine group and between the placebo group and the bupivacaine
with epinephrine group, however, no difference in 1, 6, 12 and every 6 hours after.
There was no significant difference in post-operative analgesia requirements, nausea/vomiting
scores, time to ambulation, hospital length of stay, or time to return to work after
discharge.
Conclusion
The efficacy of TAP block is not apparent likely due to the ERAS protocol set in place
for bariatric surgery, which already targets early postoperative pain control and
mobility.
Keywords
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Article Info
Publication History
Published online: August 01, 2018
Accepted:
July 17,
2018
Received in revised form:
July 12,
2018
Received:
June 1,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
