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Kalu R, Boateng P, Carrier L, et al. Effect of preoperative versus postoperative use of transversus abdominis plane block with plain 0.25 % bupivacaine on postoperative opioid use: a retrospective study. BMC Anesthesiol. 2021;21(1):114doi: 10.1186/s12871-021-01333-6.
Kalu, R., Boateng, P., Carrier, L., Garzon, J., Tang, A., Reickert, C., & Stefanou, A. (2021). Effect of preoperative versus postoperative use of transversus abdominis plane block with plain 0.25 % bupivacaine on postoperative opioid use: a retrospective study. BMC anesthesiology, 21(1), 114. https://doi.org/10.1186/s12871-021-01333-6
Kalu, Richard, et al. "Effect of preoperative versus postoperative use of transversus abdominis plane block with plain 0.25 % bupivacaine on postoperative opioid use: a retrospective study." BMC anesthesiology vol. 21,1 (2021): 114. doi: https://doi.org/10.1186/s12871-021-01333-6
Kalu R, Boateng P, Carrier L, Garzon J, Tang A, Reickert C, Stefanou A. Effect of preoperative versus postoperative use of transversus abdominis plane block with plain 0.25 % bupivacaine on postoperative opioid use: a retrospective study. BMC Anesthesiol. 2021 Apr 12;21(1):114. doi: 10.1186/s12871-021-01333-6. PMID: 33845790; PMCID: PMC8040194.
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BMC Anesthesiol. 2021 Apr 12;21(1):114. doi: 10.1186/s12871-021-01333-6.

Effect of preoperative versus postoperative use of transversus abdominis plane block with plain 0.25 % bupivacaine on postoperative opioid use: a retrospective study.

BMC anesthesiology

Richard Kalu, Peter Boateng, Lauren Carrier, Jaime Garzon, Amy Tang, Craig Reickert, Amalia Stefanou

Affiliations

  1. Department of Surgery, Henry Ford Hospital, 2799 W. Grand Blvd, MI, 48202, Detroit, USA.
  2. Department of Anesthesiology, Henry Ford Hospital, 2799 W. Grand Blvd, 48202, Detroit, MI, USA.
  3. Department of Public Health Sciences, Henry Ford Health System, One Ford Place, 48202, Detroit, MI, USA.
  4. Division of Colon and Rectal Surgery, Henry Ford Hospital, 2799 West Grand Blvd Detroit, 48202, Detroit, MI, USA.
  5. Division of Colon and Rectal Surgery, Henry Ford Hospital, 2799 West Grand Blvd Detroit, 48202, Detroit, MI, USA. [email protected].

PMID: 33845790 PMCID: PMC8040194 DOI: 10.1186/s12871-021-01333-6

Abstract

BACKGROUND: Enhanced recovery protocols optimize pain control via multimodal approaches that include transversus abdominis plane (TAP) block. The aim of this study was to evaluate the effect of preoperative vs. postoperative plain 0.25 % bupivacaine TAP block on postoperative opioid use after colorectal surgery.

METHODS: A retrospective cohort study comparing postoperative opioid use in patients who received preoperative (n = 240) vs. postoperative (n = 22) plain 0.25 % bupivacaine TAP blocks. The study was conducted in a single tertiary care institution and included patients who underwent colorectal resections between August 2018 and January 2020. The primary outcome of the study was postoperative opioid use. Secondary outcomes included operative details, length of stay, reoperation, and readmission rates.

RESULTS: Patients who received postoperative plain 0.25 % bupivacaine TAP blocks were less likely to require postoperative patient-controlled analgesia (PCA) (59.1 % vs. 83.3 %; p = 0.012) and opioid medications on discharge (6.4 % vs. 16.9 %; p = 0.004) relative to patients who received preoperative TAP. When needed, a significantly smaller amount of opioid was prescribed to the postoperative group (84.5 vs. 32.0 mg, p = 0.047). No significant differences were noted in the duration of postoperative PCA use, amount of oral opioid use, and length of stay.

CONCLUSIONS: Plain 0.25 % bupivacaine TAP block administered postoperatively was associated with significantly lower need for postoperative PCA and discharge opioid medications. The overall hospital length of stay was not affected by the timing of TAP block. Because of the limited sample size in this study, conclusions cannot be generalized, and more research will be required.

Keywords: Preemptive analgesia; TAP block; Transversus abdominis plane block

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