Ultrasound Blocks for the Anterior Abdominal Wall

10. Other Abdominal Surgery Procedures | 81
TAPB employed for laparoscopic colonic-rectal resections
reduces overall postoperative morphine (31.3 vs. 51.8 mg) and
hospital stay (Conaghan 2010). In a retrospective analysis of
patients undergoing laparoscopic colonic-rectal resection, an
ultrasound-guided TAPB significantly reduced time to the
resumption of diet and postoperative hospital stay (Zafar 2010).
Ultrasound-guided TAPB in patients undergoing laparoscopic
cholecystectomy was associated with a significant reduction in
the administration of intraoperative sufentanyl and
postoperative morphine (10.5 +/- 7.7 vs. 22.8 ± 4.3 mg)
(El-Dawlatly 2009).
Kidney surgery
TAPB may reduce pain scores and morphine requirements in
patients undergoing renal transplant (Jankovic 2009 (2)). Pain
scores and intraoperative opioid need may be reduced for 12
hours (Mukhtar 2010). Kidney transplant recipients receiving IIB
and block of T11 to 12 intercostal nerves show reduced
postoperative pain and total morphine consumption (12.7 +/-
10.5 mg vs. 34.9 +/- 5.9 mg) (Shoeibi 2009). Subcostal bilateral
TAPB with catheters compared to epidural analgesia in adult
patients undergoing elective open hepatic-biliary or kidney
surgery, provided no significant differences in pain scores at rest
and during coughing at 8, 24, 48 and 72 h after surgery.
Tramadol consumption was significantly greater in the TAP
group (Niraj 2011). Patients received bupivacaine 0.375%
bilaterally every 8 h in the TAM plane and an epidural infusion
of bupivacaine 0.125% with fentanyl 2 mcg/ml.
A novel ‘semi blind’ technique of administering the TAPB
through the laparoscopic camera during nephrectomy has been
described (Chetwood 2011).