TAP blocks

[urge]

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Liposomal Bupivacaine, Plain Bupivacaine, and Saline for... : Anesthesiology

effectiveness remains unclear. Therefore, two coprimary hypotheses were tested: first, that opioid consumption during the initial 24 postoperative hours is higher with saline than plain bupivacaine or liposomal bupivacaine; and second, that opioid consumption between 24 to 48 h after surgery is...

journals.lww.com

Are fascial plane blocks bogus?

 

[2019medstudent]

Where's that doc who does TAPs for all lap procedures?

 

[UscGhost]

Where's that doc who does TAPs for all lap procedures?

Hes probably busy following the ASA taskforce guidelines...that specifically recommend them...

ASA Perioperative Pain Management Using Local and Regional Analgesia for Cardiothoracic Surgeries, Mastectomy, and Abdominal Surgeries Guideline Summary - Guideline Central

www.guidelinecentral.com

 

[aneftp]

Would you do a tap block for elective robot gallbladder Easter morning Sunday at 4am after working 21 hours straight with another case to follow another robot lap appy? All solo

True story.

I would not do it out of principal that working 21 hours in a row solo already

 

[psychbender]

Would you do a tap block for elective robot gallbladder Easter morning Sunday at 4am after working 21 hours straight with another case to follow another robot lap appy? All solo

True story.

I would not do it out of principal that working 21 hours in a row solo already

There's so much wrong with that story besides the TAP block question.

 

[JoelJoel84]

For those who don’t want to click through to the article:

Conclusions:​

Single-shot, four-quadrant TAP blocks performed with liposomal bupivacaine, plain bupivacaine, or normal saline before incision for various open and laparoscopic abdominal procedures resulted in similar postoperative opioid consumption and pain scores at 24, 48, and 72 h. Absence of early benefit suggests that routine preincision, single-shot TAP blocks in this mixed surgical population provide little analgesia.

 

[UscGhost]

For those who don’t want to click through to the article:

Conclusions:​

Single-shot, four-quadrant TAP blocks performed with liposomal bupivacaine, plain bupivacaine, or normal saline before incision for various open and laparoscopic abdominal procedures resulted in similar postoperative opioid consumption and pain scores at 24, 48, and 72 h. Absence of early benefit suggests that routine preincision, single-shot TAP blocks in this mixed surgical population provide little analgesia.

Of note..

Same author concluded that TAP blocks were comparable to epidurals

https://www.anesthesiologynews.com/Clinical-Anesthesiology/Article/04-21/TAP-Block-Liposomal-Bupivacaine-Epidural/63136

 

[gunnershow]

Would you do a tap block for elective robot gallbladder Easter morning Sunday at 4am after working 21 hours straight with another case to follow another robot lap appy? All solo

True story.

I would not do it out of principal that working 21 hours in a row solo already

Time of day doesn't affect my anesthetic. But I won't be doing these for a robot gallbladder anyway. Incarcerated hernia.. yeah I would.

 

[cittykat]

Good read.

Few points stick out for me.

1. No mention of intraoperative opioid doses.

2. Pacira funded study.

3. Blocks performed prior to incision.

4. Close to zero Asian and Hispanic patients.