Efficacy and safety of transversus abdominis plane blocks versus thoracic epidural anesthesia in patients undergoing major abdominal oncologic resections: A prospective, randomized controlled trial

Am J Surg. 2018 Mar;215(3):498-501. doi: 10.1016/j.amjsurg.2017.10.055. Epub 2017 Nov 16.

Abstract

Background: The purpose of this study was to compare patient outcomes for thoracic epidural anesthesia (TEA) with transversus abdominis plane (TAP) blocks.

Methods: A prospective, randomized trial was performed for patients undergoing abdominal oncologic surgeries.

Results: There 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.

Conclusions: TAP block use was associated with lower parenteral morphine equivalent usage and decreased incidence of hypotension in the early post-operative period compared to TEA.

Keywords: Abdominal; Epidural anesthesia; Surgery; TAP block; Transversus abdominis plane block.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abdomen / innervation
  • Abdomen / surgery
  • Abdominal Muscles / innervation*
  • Abdominal Neoplasms / surgery*
  • Adult
  • Aged
  • Anesthesia, Epidural*
  • Female
  • Fluid Therapy
  • Humans
  • Hypotension / etiology*
  • Hypotension / prevention & control
  • Hypotension / therapy
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain, Postoperative / prevention & control*
  • Prospective Studies
  • Thoracic Vertebrae
  • Treatment Outcome