ESRA Academy. Murphy E. Sep 8, 2016; 138380; 0220 Topic: Trunk Blocks
Emma Murphy
Emma Murphy

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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.


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.


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.


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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