The Role of the Transversus Abdominis Plane (TAP) Block in Robotic Donor Nephrectomies
1College of Medicine, Upstate Medical University, Syracuse, NY, 2Anesthesiology, SUNY, Upstate Medical University, Syracuse, NY, 3Surgery, Division of Transplantation, SUNY, Upstate Medical University, Syracuse, NY, 4Medicine, SUNY, Upstate Medical University, Syracuse, NY, 5Pathology, SUNY, Upstate Medical University, Syracuse, NY, 6Medicine, SUNY, Upstate Medical University, Syracuse, NY
Meeting: 2022 American Transplant Congress
Abstract number: 1053
Keywords: Donation, Kidney transplantation, Laparoscopy, Pain
Topic: Clinical Science » Kidney » 40 - Kidney Living Donor: Other
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: In recent years, there has been growing interest in the transversus abdominis plane (TAP) block for a variety of abdominal surgeries. Post-operative pain following donor nephrectomy is significant and opioid analgesia in standard doses is often ineffective and associated with numerous adverse effects. Our aims were to explore differences in post-operative morphine milligram equivalents (MME) in patients who underwent robotic donor nephrectomy (RDN), divided into TAP and non-TAP block groups
*Methods: This is a retrospective study comparing post-operative MMEs for living donor nephrectomies at a single institution. The results of 57 consecutive live robotic donor nephrectomies performed from May 2018 to October 2021 were reviewed. Patients either received a TAP block in the immediate pre-operative period or did not receive any TAP block or similar regional anesthesia. The two approaches were compared by collecting information on PRN opioids administered in hospital as measured in MMEs, average post-operative pain scores, post-operative complications and length of hospital stay
*Results: A total of 57 consecutive live donors were distributed across both groups, with 14 in the TAP group and 43 in the non-TAP group. Operations were performed on patients with similar gender distribution (female – 11/14 vs 30/43, p=0.74) and BMI (26.8 vs. 27.1, p= 0.58). There was a significant difference in laterality among groups, with 14/14 within TAP having a left-sided procedure in contrast to 29/43 in the non-TAP group (p=0.013). Intra-operatively, the TAP group had significantly less blood loss (23.9 vs. 77.8, p=0.025) but there were no differences in operative times, complications, or intra-operative fluid requirements. Post-operatively, MME were significantly lower in the TAP group (274 vs. 1394, p<0.01) as was hospitalization time (2.0 vs. 2.6 days, p=0.04). However, there was no significant difference in patient reported pain score (3.65 vs. 3.61, p=0.945). There are no significant differences in kidney function, as measured by both eGFR and serum creatinine, at the 1-month, 3-month, 6-month, and 1-year post-operatively
*Conclusions: This study has demonstrated that TAP blocks are a safe and effective form of analgesia with potential to reduce post-operative opioid use, as evaluated by morphine milligram equivalents, and to reduce hospitalization stay
To cite this abstract in AMA style:
Popovic A-, Oehler J, Loerzel S, Hanlon M, Iskhagi S, Shaban E, Dvorai RH, Leggat J, Gallay B, Saidi R, Shahbazov R. The Role of the Transversus Abdominis Plane (TAP) Block in Robotic Donor Nephrectomies [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/the-role-of-the-transversus-abdominis-plane-tap-block-in-robotic-donor-nephrectomies/. Accessed May 17, 2025.« Back to 2022 American Transplant Congress