Posterior Ultrasound-guided Transversus Abdominis Plane Effectively Promotes Dermatomal Sensory Blockage

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Posterior Ultrasound-guided Transversus Abdominis Plane Effectively Promotes Dermatomal Sensory Blockage

According to a recent research study published in the Journal of Anaesthesiology Clinical Pharmacology, the Ultrasound (US)-guided transverse abdominis plane (TAP) efficiently promotes sensory block associated with various dermatomes using posterior approach and provides an anesthetic effect.

Tomonori Furuya and colleagues conducted the randomized controlled trial to compare lateral or posterior US-guided TAP to block dermatomal sensory segments. The US-guided TAP block is an effective method to provide relief from postoperative pain. Generally, the lateral approach is used intensively to deliver postoperative analgesic effect after lower abdominal surgeries. The posterior approach is used after transverse lower abdominal incision achieved by blockage of anterior ramus of spinal nerve posteriorly.

A total of 30 females of age 20 to 79 years who underwent laparoscopic resection of ovarian tumors under general anesthesia were selected for the analysis. Out of 30 females, three were excluded from the trial as they were discovered with psychiatric diseases. Fourteen patients who received Lateral TAP (LTAP) were categorized as group L, and the other thirteen patients received Posterior TAP (PTAP) and were classified under group P. Patients received bilateral TAP blocks with 15 ml of 0.25% levobupivacaine on each side before the introduction of general anesthesia to generate dermatomal sensory blockage. Median, the interquartile range (IQR) was used to evaluate the outcomes.

The number of dermatomes blocked with PTAP was higher with more cephalad dermatome blockage (IQR 3–4; IQR T-9–T-10) and to sharp touch as compared to LTAP (IQR 2–2; IQR T-10–T-10), 20 min after introduction of TAP blocks.

Therefore, in females with laparoscopic resection of ovary tumors, PTAP provided a sensory block affecting an increased number of dermatomes and a more cephalad sensory block to sharp touch in comparison to LTAP block. However, improvement and modification of the PTAP technique, including needle approach and injectate deposition, is required to improve the effectiveness and authenticity of the block for a postoperative analgesia technique following several abdominal surgeries.

Source

Journal of Anaesthesiology Clinical Pharmacology      

Link:

http://www.joacp.org/article.asp?issn=0970-9185;year=2018;volume=34;issue=2;spage=205;epage=210;aulast=Furuya

The original title of article:

Comparison of dermatomal sensory block following ultrasound-guided transversus abdominis plane block by the lateral and posterior approaches: A randomized controlled trial

Authors:

Tomonori Furuya et al.

SearchTags: 
Therapeutic, Postoperative pain, Randomized Controlled Trial, Efficacy, Safety
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