Efficacy and safety of transversus abdominis plane blocks versus thoracic epidural anesthesia in patients undergoing major abdominal oncologic resections: A prospective,randomized controlled trial |
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| Authors: | Tamer M. Shaker Joseph T. Carroll Mathew H. Chung Tracy J. Koehler Brian R. Lane Andrea M. Wolf G. Paul Wright |
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| Affiliation: | 1. Spectrum Health General Surgery Residency Program, Grand Rapids, MI, United States;2. Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States;3. Grand Rapids Medical Education Partners, Research Department, Grand Rapids, MI, United States;4. Division of Urology, Spectrum Health Medical Group, Grand Rapids, MI, United States;5. Betz Family Endowment for Cancer Research, Grand Rapids, MI, United States;6. Section of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, MI, United States |
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| Abstract: | BackgroundThe purpose of this study was to compare patient outcomes for thoracic epidural anesthesia (TEA) with transversus abdominis plane (TAP) blocks.MethodsA prospective, randomized trial was performed for patients undergoing abdominal oncologic surgeries.ResultsThere were 32 TAP and 35 TEA subjects. The TEA group demonstrated increased episodes of hypotension in the first 24 h (3 v 0.6, p = 0.02). There was no difference in 24–48 h fluid balance between the groups. Overall parenteral morphine equivalents of opioids administered for the TEA group were higher for each postoperative day (p < 0.05). The post-operative survey did not demonstrate any difference in subjective pain between the TAP and TEA groups (6 v 6 p = 0.35). There was no attributable morbidity associated with either technique.ConclusionsTAP block use was associated with lower parenteral morphine equivalent usage and decreased incidence of hypotension in the early post-operative period compared to TEA. |
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| Keywords: | Surgery Abdominal Epidural anesthesia Transversus abdominis plane block TAP block |
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