Title
Transversus Abdominis Plane Blocks With Abdominoplasty
Transversus Abdominis Plane Blocks in Patients Scheduled for an Abdominoplasty. A Prospective, Randomized, Double Blind, Comparison Between the Posterior Approach and Placebo.
Phase
Phase 4Lead Sponsor
Clinique Saint-Jean, BruxellesStudy Type
InterventionalStatus
Unknown statusIndication/Condition
Post Operative PainIntervention/Treatment
ropivacaine ...Study Participants
60Comparing morphine consumption and recovery with two different TAP block techniques after abdominoplasty.
TAP blocks have the potential to become an important part of multi-modal analgesia after abdominal surgery (1,2). Originally Dr J McDonnell described a blind double pop technique, trough the triangle of Petit, with up to 48 hours of analgesia (3,4). Dr P Hebbard described an ultrasound based technique with a subcostal (for supra-umbilical analgesia) and an axillary mid-line injection (for sub-umbilical analgesia) in the TAP, with reported analgesia for up to 8 hours (5,6). Recently Dr J McDonnell presented data showing para vertebral spread (up to L5) of the (high dose, low concentration) local anaesthetic explaining the prolonged analgesic effect (7,8). In 2007 Dr Blanco described an ultrasound guided technique for the posterior infiltration as performed by McDonnell (9). Our limited observational comparison between both block techniques confirms this difference. We decided to compare both techniques (the ultrasound guided single shot subcostal injection, the aTAP-group (Hebbard is from Australia) and the ultrasound guided posterior injection, the iTAP-group (McDonnell is from Ireland). We will use the same volume and concentration of local anesthetic and we will asses their analgesic efficacy and improvement in quality of recovery.
Posterior approach for TAP: ultrasound guided bilateral needle insertion in the transversus abdominis plane, anterior to the quadratus lumborum muscle
Subcostal approach for TAP: US guided needle insertion in the transversus abdominis plane, lateral to rectus sheet
Posterior approach for TAP: ultrasound guided bilateral needle insertion in the transversus abdominis plane, anterior to the quadratus lumborum muscle
Subcostal approach for TAP: US guided needle insertion in the transversus abdominis plane, lateral to rectus sheet
Inclusion Criteria: Eligible for abdominoplasty ASA 1-2 Fluent french/dutch/english Exclusion Criteria: History of allergy to local anaesthetics Chronic opioids abuse Pregnant patients
