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CONTINUOUS TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCKADE FOR POST-OPERATIVE ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERY – IS THE TIDE CHANGING?
Author(s): ,
FOO, C.W.*
Affiliations:
KHOO TECK PUAT HOSPITAL, ANAESTHESIA, SINGAPORE, Singapore
,
WONG, M.H.
Affiliations:
KHOO TECK PUAT HOSPITAL, ANAESTHESIA, SINGAPORE, Singapore
,
CHNG, K.
Affiliations:
KHOO TECK PUAT HOSPITAL, ANAESTHESIA, SINGAPORE, Singapore
QUEK, C.
Affiliations:
KHOO TECK PUAT HOSPITAL, ANAESTHESIA, SINGAPORE, Singapore
ESRA Academy. Foo C. Sep 13, 2017; 190962
Topic: Acute Postoperative Pain - Postoperative & Perioperative Analgesia
Dr. Chek Wun Foo
Dr. Chek Wun Foo
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Abstract
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Background and Aims:

Patients who undergo major abdominal surgery are at risk of developing acute post-operative pain and it is vital to ensure that they receive adequate post-operative analgesia. Continuous TAP blockade has been shown to be non-inferior to epidural analgesia as part of multimodal pain management for these patients.

Since 2013, our department has initiated the practice of continuous TAP blockade for patients who undergo abdominal surgery to address the issue of opioid-sparing post-operative pain control. Compared to epidurals, the continuous TAP blockade under ultrasound guidance has a less acute learning curve which residents/registrars would be able to perform with greater confidence. This study objective is to review the trend of continuous TAP and Thoracic Epidural Analgesia (TEA) insertion for abdominal surgery performed by residents

Methods:

After obtaining DSRB approval, a retrospective data collection was performed on surgical patients who received either continuous TAP blockade or TEA for major abdominal surgery from 01 Jan 2014 to 1 Jan 2016.

Results:

112 TEA and 84 continuous TAP blockade were performed in 2014 whilst 68 TEA and 144 continuous TAP blockade were performed in 2015 for major abdominal surgery. 27% and 33.8% of TEA were performed by junior anesthesiologists (residents, registrars or fellows) whilst 77.7% (103) and 75.4% (126) continuous TAP blockade were performed by the junior staff in 2014 and 2015 respectively. 

Conclusions:

With the introduction of TAP catheters, the number of epidurals for abdominal surgery is on the downward trend. Continuous TAP blockade is relatively easier to perform but also offer opioid-sparing analgesia.

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