Does Transversus Abdominis Plane Block Reduce Opioid Analgesic Requirements in the Post-Operative Period in Renal Transplant Recipients?
1Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, Tyne and Wear, United Kingdom
2Department of Anesthesia, Freeman Hospital, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
Meeting: 2015 American Transplant Congress
Abstract number: C232
Keywords: Kidney transplantation, Pain
Session Information
Session Name: Poster Session C: Surgical Issues/Ureteral Complications
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Introduction: Renal transplant recipients are a challenge where pain management is concerned. The theory that transversus abdominis plane (TAP) block provides additional analgesic benefit reducing opioid intake is investigated in this study.
Methods: 161 consecutive live related renal transplant recipients from 2009 to 2011 were included (TAP block n=76, No-TAP n=85). Both groups received paracetamol and standard patient controlled fentanyl analgesia. Data was collected for patient demographics, fentanyl requirements, nausea, sedation and pain scores intraoperatively, in recovery and at 24 hours. Primary outcome:total fentanyl consumption in first 24 hours; other outcomes: pain scores, nausea, vomiting and sedation.
| TAP (n=76) | No TAP (n=85) | p value | |
| BMI Median (Range) | 26 (18-47) | 26 (18-38) | 0.98 |
| Sex (M: F) | 1.4: 1 | 1.5: 1 | 0.919 |
| Age | 41 (18-71) | 46 (10-71) | 0.35 |
| ASA I | 0 | 1 | >0.05 |
| II | 6 | 15 | |
| III | 71 | 49 | |
| IV | 0 | 4 |
Results: Fentanyl use was significantly different between the two groups in the Intra-operative (IO) period (Median (range) TAP: 277 mcg (100-600) vs. No-TAP: 329 mcg (100-800), p=0.003). However, this did not progress to statistical significance in terms of fentanyl requirement on the ward (p=0.57) and total fentanyl requirement in the first 24 hour period (p=0.181). There was a non-significant trend towards lesser Fentanyl use in recovery (TAP [279 mcg (0-2250) vs. No-TAP 390 mcg (0-2600), p=0.08). A subgroup analysis revealed no benefit of a bilateral TAP over unilateral block. No difference was found between the two groups with regards to Nausea score (p=0.77) as well as Sedation score (p=0.54),.
| TAP Block (n=76) | No TAP (n=85) | p value | |
| Fentanyl consumption in mcg | 277 (100-600) | 329 (100-800) | 0.003 |
| Theatre recovery | 279 (0-2250) | 390 (0-2600) | 0.08 |
| 24 hours Ward (mcg) | 1375 (50-3100) | 1425 (100-3950) | 0.558 |
| Total consumption | 1950 (300-4500) | 2085 (425-7350) | 0.775 |
| Average Pain Score NRS (0-10) | |||
| Theatre recovery | 5 (0-10) | 5 (0-10) | 0.8 |
| 24 hrs Ward | 6(2-9) | 5 (0-9) | 0.07 |
| Nausea and Sedation scores | |||
| Nausea Score | |||
| 0 | 71 | 80 | 0.77 |
| 1 | 3 | 4 | |
| 2 | 2 | 1 | |
| Sedation Score | |||
| 0 | 22 | 20 | |
| 1 | 42 | 45 | 0.5 |
| 2 | 12 | 19 |
Conclusions: Tap block provided an analgesic benefit leading to reduced opioid requirement intra-operatively as well as in the recovery in our study. However this was a limited effect that did not extend beyond the immediate post-operative period.
To cite this abstract in AMA style:
Afridi F, Coates R, Wright S, French J, Talbot D, Rita S. Does Transversus Abdominis Plane Block Reduce Opioid Analgesic Requirements in the Post-Operative Period in Renal Transplant Recipients? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/does-transversus-abdominis-plane-block-reduce-opioid-analgesic-requirements-in-the-post-operative-period-in-renal-transplant-recipients/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress