Use of transversus abdominis plane block to decrease pain scores and narcotic use following robot-assisted...

Area of Science:

• Anesthesiology
• Surgical Pain Management
• Regional Anesthesia

Background:

• Robot-assisted laparoscopic prostatectomy (RALP) necessitates effective postoperative pain management.
• Optimizing pain control can improve patient recovery and reduce opioid reliance.

Purpose of the Study:

• To evaluate the efficacy of transversus abdominis plane (TAP) blocks in reducing pain and opioid consumption within 24 hours after RALP.
• To assess the impact of TAP blocks on patient ambulation time and overall recovery.

Main Methods:

• A prospective study involving 100 patients receiving TAP blocks prior to RALP, compared retrospectively to 100 propensity-matched controls.
• Pain scores, intra/post-operative narcotic use, and time to ambulation were analyzed.
• TAP block administration time and operating room (OR) time were recorded.

Main Results:

• TAP block recipients reported significantly lower immediate post-operative pain (2.23 vs 4.26) and 24-hour pain scores (p<0.001).
• Patients receiving TAP blocks ambulated significantly faster (2.68 vs 4.91 hours, p<0.000) and required less intra-operative and post-operative narcotic medication.
• The average TAP block procedure added only 3.5 minutes to the total OR time (p=0.386).

Conclusions:

• Transversus abdominis plane (TAP) blocks are an effective adjunct to perioperative pain management protocols for RALP.
• TAP blocks significantly decrease pain, reduce narcotic requirements, and accelerate patient ambulation post-RALP without substantially increasing operative time.