Laparoscopic-Assisted Transversus Abdominis Plane (TAP) Block Versus Port-Site Infiltration with Local Anesthetics in Bariatric Surgery: a Double-Blind Randomized Controlled Trial
Background The transversus abdominis plane (TAP) block has shown great potential usefulness in the management of postoperative pain; however, there is lacking evidence regarding its use in bariatric surgery. This randomized double-blind trial was aimed at comparing the effectiveness of the TAP block...
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| Veröffentlicht in: | Obesity surgery 2023-11, Vol.33 (11), p.3383-3390 |
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| creator | Mongelli, Francesco Marengo, Michele Bertoni, Maria Vittoria Volontè, Francesco Ledingham, Nicola Susan Garofalo, Fabio |
| description | Background
The transversus abdominis plane (TAP) block has shown great potential usefulness in the management of postoperative pain; however, there is lacking evidence regarding its use in bariatric surgery. This randomized double-blind trial was aimed at comparing the effectiveness of the TAP block and port-site infiltration (PSI) in patients undergoing bariatric surgery.
Methods
We included patients ≥ 18 years old undergoing bariatric surgery. From July 2020 to July 2021, all eligible patients were randomized to receive either laparoscopic-assisted TAP block or PSI. Demographic and clinical data were collected and analyzed.
Results
During the study period, we included 113 patients. Fifty-one were allocated to the TAP block group and 62 to the PSI group. The mean age was 47.9 ± 11.2 years, 88 (77.9%) patients were female, and mean BMI was 40.5 ± 5.9 kg/m
2
. Operative time was 110 ± 42 min vs. 114 ± 41 min in the TAP block and PSI groups (
p
= 0.658). At 24 h after surgery, pain on the VAS was 2.5 ± 2.6 vs. 2.3 ± 2.1 (
p
= 0.661). No significant difference between the groups was noted at 3, 6, 12, and 18 h. Also, opioid and antiemetic consumption, the length of stay (3.4 ± 1.5 days vs. 3.2 ± 1.1 days,
p
= 0.392), and satisfaction score (154 ± 10 pts vs. 154 ± 16 pts,
p
= 0.828) were similar in the two groups.
Conclusions
Patients undergoing bariatric surgery and receiving either the TAP block or the PSI had similar postoperative pain, nausea, length of stay, and satisfaction. As PSI is technically easier and more reproducible, it might be the first choice for postoperative multimodal analgesia in bariatric surgery.
Graphical Abstract |
| doi_str_mv | 10.1007/s11695-023-06825-7 |
| format | Article |
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The transversus abdominis plane (TAP) block has shown great potential usefulness in the management of postoperative pain; however, there is lacking evidence regarding its use in bariatric surgery. This randomized double-blind trial was aimed at comparing the effectiveness of the TAP block and port-site infiltration (PSI) in patients undergoing bariatric surgery.
Methods
We included patients ≥ 18 years old undergoing bariatric surgery. From July 2020 to July 2021, all eligible patients were randomized to receive either laparoscopic-assisted TAP block or PSI. Demographic and clinical data were collected and analyzed.
Results
During the study period, we included 113 patients. Fifty-one were allocated to the TAP block group and 62 to the PSI group. The mean age was 47.9 ± 11.2 years, 88 (77.9%) patients were female, and mean BMI was 40.5 ± 5.9 kg/m
2
. Operative time was 110 ± 42 min vs. 114 ± 41 min in the TAP block and PSI groups (
p
= 0.658). At 24 h after surgery, pain on the VAS was 2.5 ± 2.6 vs. 2.3 ± 2.1 (
p
= 0.661). No significant difference between the groups was noted at 3, 6, 12, and 18 h. Also, opioid and antiemetic consumption, the length of stay (3.4 ± 1.5 days vs. 3.2 ± 1.1 days,
p
= 0.392), and satisfaction score (154 ± 10 pts vs. 154 ± 16 pts,
p
= 0.828) were similar in the two groups.
Conclusions
Patients undergoing bariatric surgery and receiving either the TAP block or the PSI had similar postoperative pain, nausea, length of stay, and satisfaction. As PSI is technically easier and more reproducible, it might be the first choice for postoperative multimodal analgesia in bariatric surgery.
Graphical Abstract</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-023-06825-7</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Clinical trials ; Double-blind studies ; Gastrointestinal surgery ; Laparoscopy ; Length of stay ; Local anesthesia ; Medicine ; Medicine & Public Health ; Original Contributions ; Surgery</subject><ispartof>Obesity surgery, 2023-11, Vol.33 (11), p.3383-3390</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-b2eab25900e4257f29d1c4ec0cd4d15c5d1c04f0c6a9d1910b061bf9446de40a3</citedby><cites>FETCH-LOGICAL-c352t-b2eab25900e4257f29d1c4ec0cd4d15c5d1c04f0c6a9d1910b061bf9446de40a3</cites><orcidid>0000-0002-8824-651X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-023-06825-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-023-06825-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Mongelli, Francesco</creatorcontrib><creatorcontrib>Marengo, Michele</creatorcontrib><creatorcontrib>Bertoni, Maria Vittoria</creatorcontrib><creatorcontrib>Volontè, Francesco</creatorcontrib><creatorcontrib>Ledingham, Nicola Susan</creatorcontrib><creatorcontrib>Garofalo, Fabio</creatorcontrib><title>Laparoscopic-Assisted Transversus Abdominis Plane (TAP) Block Versus Port-Site Infiltration with Local Anesthetics in Bariatric Surgery: a Double-Blind Randomized Controlled Trial</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><description>Background
The transversus abdominis plane (TAP) block has shown great potential usefulness in the management of postoperative pain; however, there is lacking evidence regarding its use in bariatric surgery. This randomized double-blind trial was aimed at comparing the effectiveness of the TAP block and port-site infiltration (PSI) in patients undergoing bariatric surgery.
Methods
We included patients ≥ 18 years old undergoing bariatric surgery. From July 2020 to July 2021, all eligible patients were randomized to receive either laparoscopic-assisted TAP block or PSI. Demographic and clinical data were collected and analyzed.
Results
During the study period, we included 113 patients. Fifty-one were allocated to the TAP block group and 62 to the PSI group. The mean age was 47.9 ± 11.2 years, 88 (77.9%) patients were female, and mean BMI was 40.5 ± 5.9 kg/m
2
. Operative time was 110 ± 42 min vs. 114 ± 41 min in the TAP block and PSI groups (
p
= 0.658). At 24 h after surgery, pain on the VAS was 2.5 ± 2.6 vs. 2.3 ± 2.1 (
p
= 0.661). No significant difference between the groups was noted at 3, 6, 12, and 18 h. Also, opioid and antiemetic consumption, the length of stay (3.4 ± 1.5 days vs. 3.2 ± 1.1 days,
p
= 0.392), and satisfaction score (154 ± 10 pts vs. 154 ± 16 pts,
p
= 0.828) were similar in the two groups.
Conclusions
Patients undergoing bariatric surgery and receiving either the TAP block or the PSI had similar postoperative pain, nausea, length of stay, and satisfaction. As PSI is technically easier and more reproducible, it might be the first choice for postoperative multimodal analgesia in bariatric surgery.
Graphical Abstract</description><subject>Clinical trials</subject><subject>Double-blind studies</subject><subject>Gastrointestinal surgery</subject><subject>Laparoscopy</subject><subject>Length of stay</subject><subject>Local anesthesia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Contributions</subject><subject>Surgery</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kcFu1DAURS0EEkPhB1hZYlMWhmfHcRJ2mYFCpZEY0YGt5TgOdfHYg-1Qld_iB_E0SEgsWD1Z79znq3sRek7hFQVoXidKRVcTYBUB0bKaNA_QijbQEuCsfYhW0Akgbceqx-hJSjcAjArGVujXVh1VDEmHo9WkT8mmbEa8j8qnHyamOeF-GMPBepvwzilv8Pm-373Eaxf0N_xlQXYhZnJls8GXfrIuR5Vt8PjW5mu8DVo53HuT8rXJVidsPV6raFWOVuOrOX418e4NVvhtmAdnyNpZP-JPyp--_VnMbILPMTh378sq9xQ9mpRL5tmfeYY-X7zbbz6Q7cf3l5t-S3RVs0wGZtTA6g7AcFY3E-tGqrnRoEc-0lrX5Ql8Ai1U2XQUBhB0mDrOxWg4qOoMnS93jzF8n4t_ebBJG3dKIcxJsla0lHEBXUFf_IPehDn64q5QLaO04i0vFFsoXRJP0UzyGO1BxTtJQZ56lEuPsvQo73uUTRFViygV2Jes_p7-j-o3cTyi8A</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Mongelli, Francesco</creator><creator>Marengo, Michele</creator><creator>Bertoni, Maria Vittoria</creator><creator>Volontè, Francesco</creator><creator>Ledingham, Nicola Susan</creator><creator>Garofalo, Fabio</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8824-651X</orcidid></search><sort><creationdate>20231101</creationdate><title>Laparoscopic-Assisted Transversus Abdominis Plane (TAP) Block Versus Port-Site Infiltration with Local Anesthetics in Bariatric Surgery: a Double-Blind Randomized Controlled Trial</title><author>Mongelli, Francesco ; Marengo, Michele ; Bertoni, Maria Vittoria ; Volontè, Francesco ; Ledingham, Nicola Susan ; Garofalo, Fabio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-b2eab25900e4257f29d1c4ec0cd4d15c5d1c04f0c6a9d1910b061bf9446de40a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Clinical trials</topic><topic>Double-blind studies</topic><topic>Gastrointestinal surgery</topic><topic>Laparoscopy</topic><topic>Length of stay</topic><topic>Local anesthesia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Contributions</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mongelli, Francesco</creatorcontrib><creatorcontrib>Marengo, Michele</creatorcontrib><creatorcontrib>Bertoni, Maria Vittoria</creatorcontrib><creatorcontrib>Volontè, Francesco</creatorcontrib><creatorcontrib>Ledingham, Nicola Susan</creatorcontrib><creatorcontrib>Garofalo, Fabio</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mongelli, Francesco</au><au>Marengo, Michele</au><au>Bertoni, Maria Vittoria</au><au>Volontè, Francesco</au><au>Ledingham, Nicola Susan</au><au>Garofalo, Fabio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic-Assisted Transversus Abdominis Plane (TAP) Block Versus Port-Site Infiltration with Local Anesthetics in Bariatric Surgery: a Double-Blind Randomized Controlled Trial</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><date>2023-11-01</date><risdate>2023</risdate><volume>33</volume><issue>11</issue><spage>3383</spage><epage>3390</epage><pages>3383-3390</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
The transversus abdominis plane (TAP) block has shown great potential usefulness in the management of postoperative pain; however, there is lacking evidence regarding its use in bariatric surgery. This randomized double-blind trial was aimed at comparing the effectiveness of the TAP block and port-site infiltration (PSI) in patients undergoing bariatric surgery.
Methods
We included patients ≥ 18 years old undergoing bariatric surgery. From July 2020 to July 2021, all eligible patients were randomized to receive either laparoscopic-assisted TAP block or PSI. Demographic and clinical data were collected and analyzed.
Results
During the study period, we included 113 patients. Fifty-one were allocated to the TAP block group and 62 to the PSI group. The mean age was 47.9 ± 11.2 years, 88 (77.9%) patients were female, and mean BMI was 40.5 ± 5.9 kg/m
2
. Operative time was 110 ± 42 min vs. 114 ± 41 min in the TAP block and PSI groups (
p
= 0.658). At 24 h after surgery, pain on the VAS was 2.5 ± 2.6 vs. 2.3 ± 2.1 (
p
= 0.661). No significant difference between the groups was noted at 3, 6, 12, and 18 h. Also, opioid and antiemetic consumption, the length of stay (3.4 ± 1.5 days vs. 3.2 ± 1.1 days,
p
= 0.392), and satisfaction score (154 ± 10 pts vs. 154 ± 16 pts,
p
= 0.828) were similar in the two groups.
Conclusions
Patients undergoing bariatric surgery and receiving either the TAP block or the PSI had similar postoperative pain, nausea, length of stay, and satisfaction. As PSI is technically easier and more reproducible, it might be the first choice for postoperative multimodal analgesia in bariatric surgery.
Graphical Abstract</abstract><cop>New York</cop><pub>Springer US</pub><doi>10.1007/s11695-023-06825-7</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8824-651X</orcidid></addata></record> |
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| ispartof | Obesity surgery, 2023-11, Vol.33 (11), p.3383-3390 |
| issn | 0960-8923 1708-0428 |
| language | eng |
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| source | SpringerNature Journals |
| subjects | Clinical trials Double-blind studies Gastrointestinal surgery Laparoscopy Length of stay Local anesthesia Medicine Medicine & Public Health Original Contributions Surgery |
| title | Laparoscopic-Assisted Transversus Abdominis Plane (TAP) Block Versus Port-Site Infiltration with Local Anesthetics in Bariatric Surgery: a Double-Blind Randomized Controlled Trial |
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