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- Title
Laparoscopic-Guided Transversus Abdominis Plane (TAP) Block Combined with Port-Site Infiltration (PSI) for Laparoscopic Sleeve Gastrectomy in an ERABS Pathway: A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial.
- Authors
Cataldo, Rita; Bruni, Vincenzo; Migliorelli, Sabrina; Gallo, Ida Francesca; Spagnolo, Giuseppe; Gibin, Giulia; Borgetti, Miriam; Strumia, Alessandro; Ruggiero, Alessandro; Pascarella, Giuseppe
- Abstract
Purpose: Patients undergoing laparoscopic sleeve gastrectomy (LSG) commonly experience moderate to severe postoperative pain. We conducted a randomized, prospective double-blind placebo-controlled study to evaluate the analgesic effect of laparoscopic-guided TAP (LG-TAP) block after LSG in a high-volume bariatric center, applying an enhanced recovery after bariatric surgery (ERABS) pathway. Material and Methods: One hundred ten patients were randomly allocated to receive LG-TAP block with local anesthetic (LA) or saline solution (placebo), both combined with port-site infiltration with LA (LA-PSI). Primary outcome was pain score measured in post-anesthesia care unit (PACU) and at 6, 12, and 24 h after surgery. Secondary outcomes included postoperative nausea and/or vomiting (PONV), analgesic requirement, time to walking, time to flatus, length of hospital stay (LOS), and surgical complications. Results: No significant differences were observed between LG-TAP and placebo groups in postoperative analgesia, with a median (IQR) NRS of 2 (4.75–0) vs. 2 (5.25–0) in PACU, 5.5 (7–3) vs. 6 (7–4) at 6 h, 2 (6–0) vs. 3 (5.25–1.75) at 12 h, and 2 (3.75–0) vs. 1 (2–0) at 24 h; all p > 0.05. A significant difference was found in PONV in PACU (LG-TAP, 46%; placebo, 25%, p-value, 0.019) and at 6 h postoperatively (LG-TAP, 69%, placebo, 41%, p-value, 0.003). No differences were observed as regards other secondary outcomes. Conclusion: Our results suggest that LG-TAP block is not related to more effective postoperative analgesia compared to placebo when LA-PSI is performed.
- Subjects
SLEEVE gastrectomy; TRANSVERSUS abdominis muscle; SURGICAL complications; ANALGESIA; SALINE solutions; LAPAROSCOPIC surgery; GASTRIC banding
- Publication
Obesity Surgery, 2024, Vol 34, Issue 7, p2475
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-024-07292-4