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Published on: June 25, 2013
Transversus abdominis plane block or subcutaneous wound infiltration after open radical prostatectomy: a randomized
A Skjelsager1, B Ruhnau, T K Kistorp
1Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. askjelsager@gmail.com
Acta Anaesthesiologica Scandinavica
|February 8, 2013
Summary
Neither transversus abdominis plane (TAP) block nor wound infiltration effectively reduced pain after open radical retropubic prostatectomy. Standard multimodal analgesia with gabapentin, ibuprofen, and paracetamol provided comparable pain relief.
Area of Science:
- Anesthesiology
- Pain Management
- Surgical Oncology
Background:
- Open radical retropubic prostatectomy (ORRP) is associated with moderate post-operative pain.
- Effective pain management strategies are crucial for patient recovery after ORRP.
Purpose of the Study:
- To evaluate the efficacy of a transversus abdominis plane (TAP) block compared to wound infiltration and placebo in reducing post-operative pain, morphine consumption, and opioid-related side effects following ORRP.
Main Methods:
- A randomized, double-blind, placebo-controlled study involving patients undergoing ORRP under general anesthesia.
- Patients were assigned to receive either a bilateral TAP block (n=23), wound infiltration (n=25), or placebo (n=25), with all groups receiving a multimodal analgesic regimen including gabapentin, ibuprofen, paracetamol, and patient-controlled IV morphine.
Main Results:
- The primary outcome, visual analogue scale pain score during mobilization at 4 hours post-operatively, did not differ significantly between the TAP block and placebo groups (P=0.64).
- No significant differences in pain scores (at rest or during mobilization), 24-hour morphine consumption, or incidence of nausea, sedation, or vomiting were observed among the three groups.
Conclusions:
- Transversus abdominis plane (TAP) block or wound infiltration with ropivacaine did not provide additional benefit over a standard multimodal analgesic regimen for pain management after ORRP.
- The findings suggest that a basic multimodal analgesic regimen is sufficient for managing post-ORRP pain, without enhancement from TAP block or wound infiltration.
