Laparoscopic versus Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia Management after Radical Prostatectomy: Results from a Single Center Study

Author:

Civitella Angelo1,Prata Francesco1ORCID,Papalia Rocco1ORCID,Citriniti Vincenzo2,Tuzzolo Piergiorgio1,Pascarella Giuseppe2ORCID,Forastiere Ester Maria Alba3,Ragusa Alberto1ORCID,Tedesco Francesco1,Prata Salvatore Mario4,Anceschi Umberto5ORCID,Simone Giuseppe5ORCID,Muto Giovanni6,Scarpa Roberto Mario1,Cataldo Rita2ORCID

Affiliation:

1. Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy

2. Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy

3. Department of Anesthesia and Intensive Care, “Regina Elena” National Cancer Institute, 00144 Rome, Italy

4. Simple Operating Unit of Lower Urinary Tract Surgery, SS. Trinità Hospital, Sora, 03039 Frosinone, Italy

5. Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy

6. Department of Urology, GVM—Maria Pia Hospital, 10132 Turin, Italy

Abstract

(1) Background: Regional anesthesia, achieved through nerve blocks, has gained widespread acceptance as an effective pain management approach. This research aimed to evaluate the efficacy of laparoscopic (LAP) transversus abdominis plane (TAP) block in patients undergoing laparoscopic radical prostatectomy. (2) Methods: From January 2023 to July 2023, 60 consecutive patients undergoing minimally invasive radical prostatectomy were selected. Patients were split into two groups receiving ultrasound-guided (US) or laparoscopic-guided TAP block. The primary outcome was a pain score expressed by a 0−10 visual analog scale (VAS) during the first 72 h after surgery. (3) Results: Both LAP-TAP and US-TAP block groups were associated with lower pain scores postoperatively. No statistically significant differences were observed between the two groups in surgery time, blood loss, time to ambulation, length of stay, and pain after surgery (all p > 0.2). In the LAP-TAP block group, the overall operating room time was significantly shorter than in the US-TAP block group (140 vs. 152 min, p = 0.04). (4) Conclusions: The laparoscopic approach, compared to the US-TAP block, was equally safe and not inferior in reducing analgesic drug use postoperatively. Moreover, the intraoperative LAP-TAP block seems to be a time-sparing procedure that could be recommended when patient-controlled analgesia cannot be delivered.

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

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