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ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCKS REDUCE POST-OPERATIVE OPIOID CONSUMPTION IN RENAL TRANSPLANT RECIPIENTS
ESRA Academy. Murphy E. Sep 8, 2016; 138380; 0220 Topic: Trunk Blocks
Emma Murphy
Emma Murphy

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Abstract
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Background and Aims:

Renal transplantation can result in moderate post-operative pain. Several studies have shown that Transversus Abdominis plane (TAP) blocks reduce post-operative pain scores and analgesia requirements. This retrospective audit was designed to determine if the use of TAP blocks improves post-operative pain scores and reduces opioid consumption in patients undergoing renal transplantation.

Methods:

Ethical approval was sought but not required. We identified patients undergoing renal transplantation between January 2015 and March 2016. It includes three groups of patients; those with 1. Local anaesthetic wound infiltration (LAWI) by surgeons,  2. Wound catheter placed under direct visualisation, and 3. Ultrasound guided TAP catheters. Our primary outcome measures were post-operative opioid consumption and pain scores. Secondary outcomes included length of stay.

Results:

Seventy-five patients were identified as undergoing renal transplantation in our unit between January 2015 and March 2016. Twenty-seven had LAWI, 19 wound catheters, and 29 TAP catheters. Post-operative opioid consumption was highest in those with LAWI (median 1220mcg fentanyl over 24 hours) compared with wound catheters (970mcg) and TAP catheters (669mcg) (p<0.01). Pain scores were lowest in the TAP catheter group at 6 hours and 12 hours (p=0) and 48 hours (p=0.012). There was no documented difference in length of stay.

Conclusions:

Ultrasound-guided TAP catheters reduce post-operative opioid consumption in the first 24 hours and produce a significant improvement in pain scores in the first 48 hours after renal transplantation surgery.

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