Laparoscopic- vs ultrasound-guided TAP block in colorectal surgery. A randomized controlled study

Area of Science:

• Anesthesiology
• Surgical Innovation
• Pain Management

Background:

• Transversus abdominis plane (TAP) block is a key intervention for postoperative pain in colorectal surgery.
• Ultrasound-guided TAP (ULTAP) is well-established, but laparoscopic-guided TAP (LAPTAP) has shown variable outcomes.
• This study compares LAPTAP and ULTAP in minimally invasive colorectal surgery.

Purpose of the Study:

• To compare the efficacy and procedural characteristics of LAPTAP versus ULTAP.
• To evaluate postoperative pain, analgesia requirements, and procedure/anesthesia times.
• To assess feasibility of LAPTAP in minimally invasive colorectal procedures.

Main Methods:

• Randomized observer-blind controlled trial involving 175 patients undergoing minimally invasive colorectal surgery.
• Data collected on postoperative pain (VAS), analgesia use, TAP procedure time, and anesthesia duration.
• Intention-to-treat analysis with subgroup analysis based on Body Mass Index (BMI).

Main Results:

• LAPTAP group had shorter anesthesia duration (238 min vs. 265 min) and faster procedure times (2 min vs. 8 min) compared to ULTAP.
• Similar Visual Analog Scale (VAS) pain scores were observed between groups.
• No significant difference in mean postoperative pain medication dosage, but more LAPTAP patients received opioids post-operatively.

Conclusions:

• LAPTAP is a feasible and effective technique for postoperative pain management in minimally invasive colorectal surgery.
• LAPTAP provides comparable pain relief to ULTAP.
• LAPTAP offers a significant reduction in anesthesia time compared to ULTAP.