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A Comparison of the Transversus Abdo...

Talbert, Jessica.

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A Comparison of the Transversus Abdominis Plane (TAP) Block vs. Posterior Cul de Sac Catheter in Laparoscopic Robotic Hysterectomies: Pilot Study.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	A Comparison of the Transversus Abdominis Plane (TAP) Block vs. Posterior Cul de Sac Catheter in Laparoscopic Robotic Hysterectomies: Pilot Study./
作者:	Talbert, Jessica.
其他作者:	Brands, Theresa
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
面頁冊數:	72 p.
附註:	Source: Dissertations Abstracts International, Volume: 83-01, Section: A.
Contained By:	Dissertations Abstracts International83-01A.
Subject:	Nursing. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28498185
ISBN:	9798516979019

A Comparison of the Transversus Abdominis Plane (TAP) Block vs. Posterior Cul de Sac Catheter in Laparoscopic Robotic Hysterectomies: Pilot Study.
Talbert, Jessica.

A Comparison of the Transversus Abdominis Plane (TAP) Block vs. Posterior Cul de Sac Catheter in Laparoscopic Robotic Hysterectomies: Pilot Study. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 72 p.

Source: Dissertations Abstracts International, Volume: 83-01, Section: A.

Thesis (Ph.D.)--Webster University, 2021.

This item must not be sold to any third party vendors.

Introduction: A hysterectomy is the surgical removal of a uterus that can result in subjects experiencing both visceral and somatic pain. In relation to the ongoing opioid crisis, postoperative pain management is a major challenge for practitioners. Opioids are effective in managing varying levels of pain but are associated with significant side effects requiring judicious prescription. Recent pain management guidelines emphasize the importance of using regional anesthesia as part of an opioid-sparing multimodal analgesic approach. The purpose of this study is to compare the efficacy of a posterior cul de sac catheter versus a transversus abdominis plane (TAP) block in decreasing postoperative opioid consumption for subjects undergoing a laparoscopic robotic hysterectomy. Methods: A retrospective chart review of 56 medical charts was conducted for subjects who underwent a laparoscopic robotic hysterectomy at Phelps Health between June 2018 and November 2019. Subjects were divided into two groups. With an enhanced recovery after surgery (ERAS) protocol implemented to maintain homogeneity between groups, the control group received a TAP block preoperatively, whereas the experimental group received a posterior cul de sac catheter in the perioperative period. The primary outcome measured was opioid consumption (morphine equivalent (mg)) in the post anesthesia care unit (PACU). Secondary outcomes measured include subject demographics, opioid consumption intraoperatively, total opioid consumption on postoperative day (POD) 0, total opioid consumption throughout the entire hospital stay, incidence of nausea and vomiting, postoperative pain scores at various time intervals, hospital length of stay, thirty-day emergency department (ED) visit rates, and thirty-day hospital readmission rates. Results: Statistical analysis using an independent samples t-test confirmed that subjects who received a posterior cul de sac catheter (experimental group; n=41) consumed significantly less opioids (morphine equivalent (mg)) in the PACU in comparison to subjects who received a TAP block (control group; n=15) (2.879 ± 2.730 mg versus 7.633 ± 7.324 mg respectively; p value 0.026). Discussion: In summary, statistical analysis confirmed that the experimental group had decreased: opioid consumption (morphine equivalent (mg)) in the PACU, on POD 0, and throughout the entire hospital stay; decreased postoperative pain scores at 30-minutes, 45-minutes, 1 hour, 1.5 hours, 2.5 hours, on POD 1 and POD 2; hospital length of stay; incidence of postoperative nausea and vomiting; 30-day postoperative ED visit rates, and 30-day hospital readmission rates. No statistical significance was found between groups when comparing intraoperative opioid consumption due to adherence to set forth ERAS protocols.

ISBN: 9798516979019Subjects--Topical Terms:

528444
Nursing.
Subjects--Index Terms:

Acute pain

A Comparison of the Transversus Abdominis Plane (TAP) Block vs. Posterior Cul de Sac Catheter in Laparoscopic Robotic Hysterectomies: Pilot Study.
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245 1 0 $a A Comparison of the Transversus Abdominis Plane (TAP) Block vs. Posterior Cul de Sac Catheter in Laparoscopic Robotic Hysterectomies: Pilot Study.
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520 $a Introduction: A hysterectomy is the surgical removal of a uterus that can result in subjects experiencing both visceral and somatic pain. In relation to the ongoing opioid crisis, postoperative pain management is a major challenge for practitioners. Opioids are effective in managing varying levels of pain but are associated with significant side effects requiring judicious prescription. Recent pain management guidelines emphasize the importance of using regional anesthesia as part of an opioid-sparing multimodal analgesic approach. The purpose of this study is to compare the efficacy of a posterior cul de sac catheter versus a transversus abdominis plane (TAP) block in decreasing postoperative opioid consumption for subjects undergoing a laparoscopic robotic hysterectomy. Methods: A retrospective chart review of 56 medical charts was conducted for subjects who underwent a laparoscopic robotic hysterectomy at Phelps Health between June 2018 and November 2019. Subjects were divided into two groups. With an enhanced recovery after surgery (ERAS) protocol implemented to maintain homogeneity between groups, the control group received a TAP block preoperatively, whereas the experimental group received a posterior cul de sac catheter in the perioperative period. The primary outcome measured was opioid consumption (morphine equivalent (mg)) in the post anesthesia care unit (PACU). Secondary outcomes measured include subject demographics, opioid consumption intraoperatively, total opioid consumption on postoperative day (POD) 0, total opioid consumption throughout the entire hospital stay, incidence of nausea and vomiting, postoperative pain scores at various time intervals, hospital length of stay, thirty-day emergency department (ED) visit rates, and thirty-day hospital readmission rates. Results: Statistical analysis using an independent samples t-test confirmed that subjects who received a posterior cul de sac catheter (experimental group; n=41) consumed significantly less opioids (morphine equivalent (mg)) in the PACU in comparison to subjects who received a TAP block (control group; n=15) (2.879 ± 2.730 mg versus 7.633 ± 7.324 mg respectively; p value 0.026). Discussion: In summary, statistical analysis confirmed that the experimental group had decreased: opioid consumption (morphine equivalent (mg)) in the PACU, on POD 0, and throughout the entire hospital stay; decreased postoperative pain scores at 30-minutes, 45-minutes, 1 hour, 1.5 hours, 2.5 hours, on POD 1 and POD 2; hospital length of stay; incidence of postoperative nausea and vomiting; 30-day postoperative ED visit rates, and 30-day hospital readmission rates. No statistical significance was found between groups when comparing intraoperative opioid consumption due to adherence to set forth ERAS protocols.
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