| The transversus abdominis plane block: a valuable option for postoperative analgesia? A topical review. | |
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MedLine Citation:
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PMID: 20175754 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The transversus abdominis plane (TAP) block is a newly described peripheral block involving the nerves of the anterior abdominal wall. The block has been developed for post-operative pain control after gynaecologic and abdominal surgery. The initial technique described the lumbar triangle of Petit as the landmark used to access the TAP in order to facilitate the deposition of local anaesthetic solution in the neurovascular plane. Other techniques include ultrasound-guided access to the neurovascular plane via the mid-axillary line between the iliac crest and the costal margin, and a subcostal access termed the 'oblique subcostal' access. A systematic search of the literature identified a total of seven randomized clinical trials investigating the effect of TAP block on post-operative pain, including a total of 364 patients, of whom 180 received TAP blockade. The surgical procedures included large bowel resection with a midline abdominal incision, caesarean delivery via the Pfannenstiel incision, abdominal hysterectomy via a transverse lower abdominal wall incision, open appendectomy and laparoscopic cholecystectomy. Overall, the results are encouraging and most studies have demonstrated clinically significant reductions of post-operative opioid requirements and pain, as well as some effects on opioid-related side effects (sedation and post-operative nausea and vomiting). Further studies are warranted to support the findings of the primary published trials and to establish general recommendations for the use of a TAP block. |
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Authors:
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P L Petersen; O Mathiesen; H Torup; J B Dahl |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-02-17 |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 54 ISSN: 1399-6576 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-26 Completed Date: 2010-07-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
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Languages: eng Pagination: 529-35 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia, Copenhagen University Hospital, Ndr. Ringvej, DK-2600 Glostrup, Denmark. pernille.lykke.petersen@dadlnet.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Muscles
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innervation*,
surgery Analgesics, Opioid / therapeutic use Humans Morphine / therapeutic use Nerve Block / instrumentation, methods* Pain, Postoperative / prevention & control* Randomized Controlled Trials as Topic |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 57-27-2/Morphine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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