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- W3200465425 abstract "<h3>Background and Aims</h3> Ultrasound-guided (USG) Transversus Abdominis Plane (TAP) blocks are fascial plane blocks widely used because of their technical ease and analgesic implications in abdominal surgery.<sup>1</sup> However, only a few small-scale TAP studies in laparoscopic nephrectomies for tumor removal exist, none in an outpatient setting.<sup>2</sup> We assessed the impact of TAP on pain, PONV and other clinical outcomes when included in an ERAS pathway for extended ambulatory nephrectomies. <h3>Methods</h3> We performed a retrospective chart review of 209 ambulatory surgery patients who underwent partial laparoscopic and robotic nephrectomies using an ERAS protocol from 09/2016–12/2019. Preoperative TAP blocks were performed bilaterally with 20 ml of 0.25% bupivacaine or ropivacaine, 50 mcg clonidine and 2 mg dexamethasone. We assessed the association between preoperative administration USG TAP (51%) vs. no block (49%) on postoperative outcomes: intraoperative fentanyl, postoperative opioid consumption using morphine milligram equivalent units (MME), PONV rate and hours to first ambulation. <h3>Results</h3> Our results demonstrated a trend toward decreased intraoperative MME requirements in the TAP group vs no TAP (p=0.061). Patients receiving a TAP also required less postoperative narcotic (p=0.043). After adjusting for Apfel Score, age and operative time, the need for PONV rescue medication although not significant trended 8.6% higher in those without a TAP (95% CI -2.7%, 19%; p=0.11). <h3>Conclusions</h3> We found evidence that US guided bilateral TAP blocks are associated with a reduced need for postoperative narcotics in ambulatory laparoscopic and robotic nephrectomies with a trend toward decreased intraoperative MME requirements. ERAS pathways should consider including TAP blocks, even for these minimally invasive surgeries." @default.
- W3200465425 created "2021-09-27" @default.
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- W3200465425 date "2021-09-01" @default.
- W3200465425 modified "2023-09-24" @default.
- W3200465425 title "217 Effectiveness of transversus abdominis plane (TAP) blocks in ambulatory laparoscopic and robotic nephrectomies" @default.
- W3200465425 doi "https://doi.org/10.1136/rapm-2021-esra.217" @default.
- W3200465425 hasPublicationYear "2021" @default.
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