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Transversus Abdominis Plane Block Anesthesia in Abdominoplasties

Sforza, Marcos M.D.; Andjelkov, Katarina M.D., M.S.; Zaccheddu, Renato M.D.; Nagi, Hussein M.D.; Colic, Miodrag M.D., Ph.D.

Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e31821e6f51
Cosmetic: Outcomes Articles
Abstract

Background: The transversus abdominis plane block is a promising approach to the provision of postoperative analgesia following abdominal incision. This effective method blocks the sensory nerve supply to the anterior abdominal wall. The authors evaluated its analgesic efficacy over the first 12 postoperative hours after abdominoplasty with liposculpture in a randomized, controlled, double-blind clinical trial.

Methods: Twenty-eight women undergoing abdominoplasty by means of a lower abdominal incision were randomized to undergo transversus abdominis plane block (n = 14) in addition to standard care therapy (n = 14). The investigators, who were blinded to the conditions of the study, assessed the patients in the postanesthesia care unit at 4, 6, and 12 hours postoperatively.

Results: The transversus abdominis plane block group reported reduced pain scores (F = 12.73, p < 0.001). Morphine requirement was also reduced in the first 12 postoperative hours (χ2 = 19.27; p < 0.005). Transversus abdominis plane block group patients also exhibited early ambulation compared with the control group (F = 65.15, p < 0.001). All of the patients in the transversus abdominis plane block group reported lower levels of pain with their postoperative analgesic regimen, which was demonstrated by their rates of recovery. The Mann-Whitney test was performed on the data, which illustrated that mean ranks consistently corresponded to the trend the authors predicted.

Conclusions: The transversus abdominis plane block seems to hold considerable promise for patients undergoing abdominoplasty by providing effective postoperative analgesia in the first 12 postoperative hours after major abdominoplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

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Author Information

London and Bromsgrove, United Kingdom; and Belgrade, Serbia

From the UNIFESO's School of Medicine Elective Internship in Plastic Surgery; the Plastic Surgery Department, University of Belgrade; Dolan Park Hospital; and City Hospital.

Received for publication April 7, 2010; accepted October 19, 2010.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

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Marcos Sforza, M.D., 31 Weymouth Street, London W1G 7BT, United Kingdom, marcos@marcossforza.com

©2011American Society of Plastic Surgeons