The analgesic efficacy of transversus abdominis plane blocks in ileostomy takedowns: A retrospective analysis

Study Objective: To evaluate the analgesic efficacy of transversus abdominis plane (TAP) blocks in patients undergoing ileostomy reversal. Design: Retrospective chart review. Setting: University-affiliated hospital. Subjects: The charts of 104 consecutive patients who underwent ileostomy reversal between November 1, 2008 and December 31, 2009 were reviewed. The charts of 69 patients were included in the study. Of these, 31 received a preoperative TAP block. Measurements: Patients' opioid requirements intraoperatively, in the Postanesthesia Care Unit (PACU), and during the 24-hour period after discharge from the PACU were recorded and converted to intravenous (IV) morphine equivalents. Patient-reported numerical pain scores (0-10) from the PACU and from the 24-hour postoperative period also were recorded. Additional nonopioid means of perioperative analgesia were noted, as were duration of stay in the PACU and the hospital. Main Results: Patients receiving TAP blocks required statistically significantly fewer opioids intraoperatively (P = 0.002), in the PACU (P = 0.003), and over the 24-hour period postoperatively (P = 0.01) than did patients who did not receive a TAP block. Mean numerical pain scores while in the PACU and for 24 hours postoperatively also were significantly lower (P = 0.015 and P = 0.019, respectively) in patients receiving a TAP block, as were numerical pain scores immediately on arrival at the PACU (P = 0.013). Conclusion: TAP blocks are an effective means of reducing perioperative pain in patients undergoing ileostomy reversal.