*Purpose: There is lacking data regarding the use of transverse abdominis plane (TAP) blocks to reduce post-operative opioid requirements in kidney donors (KD). TAP blocks may serve as an effective adjunct in multimodal pain management to reduce the need for opioid analgesia. The purpose of this study was to review the opioid requirements of KD who did and did not receive a TAP block.

*Methods: This was a single-center, retrospective study of all patients who underwent nephrectomy for living kidney donation between September 2018 and September 2020. The primary outcome was the total milligrams of oral morphine equivalents (OMEs) used during the postoperative period to discharge. Secondary outcomes included total OMEs of non-patient controlled analgesia (PCA) IV opioids used and total OMEs of oral opioids, length of stay (LOS), 30-day readmission rates, and pain scores.

*Results: A total of 158 KD were included. There were 50 KD in the non-TAP group and 108 KD in the TAP group. Overall, the groups had similar characteristics (Table 1). The median total OME use was 235 (126-328) milligrams in the non-TAP group versus 207 (116-258) milligrams in the TAP group (p=0.064). Excluding PCA use, IV OME use was significantly lower in the TAP group [19 (8-38) vs 39(20-50) milligrams, p<0.001]. Oral OME use was similar between the non-TAP and TAP groups [75 (45-105) vs 75 (44-105), p=0.66]. Combined IV plus oral OME use was not significantly different between the non-TAP and TAP groups [118 (75-171) vs 104 (56-133), p=0.06]. Average LOS was 3.2±0.6 days for both groups. There were 3 (6%) readmissions within 30 days of discharge in the non-TAP group, two of which were for ileus and small bowel obstruction, versus 1 (<1%) readmission in the TAP group. None of the readmissions were related to pain control. The average pain score between the non-TAP and TAP groups were also similar (4.8±1.3 vs 4.8±1.2).

*Conclusions: Use of TAP blocks resulted in an overall decrease in post-operative opioid requirements among KD. TAP block use significantly reduced the amount of IV OMEs used.

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