Oh, T., Kim, J., Eom, W., Lee, S., Kim, D., Yim, J., . . . Kim, D.H. (2017). Effects of preoperative ultrasound-guided transversus abdominis plane block on pain after laparoscopic surgery for colorectal cancer: A double-blind randomized controlled trial. Surgical Endoscopy, 31, 127–134.

DOI Link

Study Purpose

To determine whether performing a preoperative ultrasound-guided transversus abdominis plane block is an effective pain control measure for laparoscopic surgery for colorectal cancer.

Intervention Characteristics/Basic Study Process

After anesthesia induction, the patient received 0.5 ml/kg of either 0.25% bupivacaine or normal saline, depending on their predetermined group assignment. Pain was assessed at rest and when coughing 1 hour after surgery, on post-op day 1, post-op day 2, and post-op day 3.

Sample Characteristics

  • N = 55   
  • AGE: 20-80 years old
  • MALES: 67%  
  • FEMALES: 33%
  • CURRENT TREATMENT: Not applicable
  • KEY DISEASE CHARACTERISTICS: Colorectal cancer 
  • OTHER KEY SAMPLE CHARACTERISTICS: Laparoscopic surgery for colorectal cancer pain

Setting

  • SITE: Single site   
  • SETTING TYPE: Inpatient    
  • LOCATION: National Cancer Center, Korea

Phase of Care and Clinical Applications

  • PHASE OF CARE: Diagnostic
  • APPLICATIONS:  Elder care, palliative care

Study Design

Randomized, double-blind, placebo-controlled trial

Measurement Instruments/Methods

Pain was measured using the numeric rating scale (NRS). Cumulative opioid use was recorded from post-anesthesia recovery, post-op day 1, post-op day 2, and post-op 3.

Results

Insignificant differences between the treatment group and control group exists when comparing post-op pain and opioid use.

Conclusions

When comparing the treatment group and control group, the differences in the postoperative pain assessments was not significant enough to support that receiving a transversus abdominis plane (TAP) block provides superior benefits.

Limitations

Small sample (< 100)

Nursing Implications

The purpose of this study was to determine whether performing a preoperative ultrasound-guided transversus abdominis plane block is an effective pain control measure for laparoscopic surgery for colorectal cancer. No differences were seen between the treatment and control group. Based on this study a transversus abdominis plane block requires additional research prior to being recommended in this indication.