Randomized Clinical Trial of Transversus Abdominis Plane Block Versus Placebo Control in Live-Donor Nephrectomy.
Hosgood SA, Thiyagarajan UM, et al.Transplantation 2012; 94(5):520-5.
Aims
The aim of this study was to determine the safety and efficacy of a transversus abdominis plane (TAP) block in patients undergoing living donor nephrectomy.
Interventions
TAP blocking with bupivacaine local anaesthetic (0.375% bupivacaine) or saline placebo (0.9% sodium chloride).
Participants
50 living kidney donors.
Outcomes
The primary outcome was postoperative morphine requirement and pain scores using the visual analogue and verbal response scales (at rest and on movement). Secondary outcomes measures included daily postoperative nausea and vomiting, daily postoperative sedation, adverse events caused by the TAP block procedure including evidence of inflammation or infection at the administration sites or adverse effects of the local anaesthetic agent or saline, assessment of recovery.
Follow-up
3 days
CET Conclusions
In this double-blinded study transversus abdominus plane (TAP) block with bupivacaine was shown to be beneficial over placebo following laparoscopic donor nephrectomy. TAP blocks were performed under ultrasound guidance. The primary outcome measure was morphine use post-operatively which was reduced in the first 6 hours post-operatively in the TAP group (12.4mg vs 21.1mg mean). The visual analogue pain score was lower in the TAP group on days 1 and 2, and patients used less oral analgesia. There was no difference in the total amount of morphine used. Patients in the control group felt more alert on day 2, there was no difference in nausea and vomiting scores or post-operative stay.
Data analysis
Modified intention-to-treat analysis
Trial registration
SRCTN14709684