Introduction: The Transversus abdominis plane (TAP) block provides a pain and opioid consumption reduction after several laparoscopic procedures. The aim of this study is to evaluate the TAP block analgesic effects during the laparoscopic colorectal resection intra and postoperative period.

Methods: Retrospective observational study during January-November 2017. Data collected from clinical records of ASA ≤3 patients who have undergone elective laparoscopic colorectal resection. Patients were divided in 2 groups, TAP group: bilateral echo guided TAP with Ropivacaine 0.5% (20ml in each side), after anaesthetic induction, plus conventional analgesia; NTAP group: conventional analgesia. Anaesthetic induction performed with fentanyl, propofol and rocuronium and desflurane maintenance. Conventional analgesic: Parecoxib 40mg and Paracetamol 1gr.
Evaluated variables: demographic characteristics; intra and postoperative, until 24h after surgery, opioid consumption, pain at rest and in movement until 24h, time spent in post anesthetic care unit (PACU), time until first Morphine bolus was requested in PACU, nausea and vomiting and conscience level.
Statistical analysis: SPPS 20. Fischer test used for categorical variables, and Mann-Whitney test used for continuous variables. P value <0.05 considered as statistical significative.

Results: 39 patients, 13 TAP and 26 NTAP. The groups were comparable concerning demographic and surgical data. It was observed lower mean intraoperative fentanyl consumption in TAP group (0,165mg) compared to NTAP (0,300mg), p<0.001. On average TAP group stayed more 14 minutes in PACU (p<0,007), but it took more time to request morphine in this unit, 18 vs 11minutes NTAP (p<0.03). It was observed no difference between the 2 groups concerning pain at 4 and 24h after surgery. No statistical difference was found in the remaining variables.

Discussion: TAP block performance didn’t result in a superior pain control. However it allowed to reduce the opioid consumption which, considering the immunosuppressive effects of these drugs, can bring an additional benefit in the Oncological field. More studies are needed to evaluate the long-term impact of this perioperative reduction in opioid consumption in these patients. 


05 / Efficacy of transversus abdominis plane block in laparoscopic colorectal resection