Ultrasound-guided transversus abdominis plane block for postoperative analgesia after varicocelectomy operations

Document Type : Original Article


1 Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Sohag University

2 Department of anesthesia and ICU, Sohag University, sohag, Egypt.

3 Department of, Anesthesia and intensive care, Fuclty of Medicine, Sohag University.


To assess the efficacy of transversus abdominis plane (TAP) block as a postoperative analgesic effectiveness. Thirty-three consecutive male patients undergoing retroperitoneal varicocele repair (Palomo technique) were enrolled in this study. Patients were randomly allocated to undergo ultrasound-guided TAP block anesthesia (case group), or conventional spinal anesthesia (control group), rescue analgesia need, nausea, and satisfaction at different time-points (6, 12, and 24 h after surgery). The post-operative evaluation, patients enrolled in the case group expressed significantly less pain on VAS score at rest and on movement at 6 (p = 0.001 and p = 0.001) and at 12 h (p = 0.004 and p = 0.01). Moreover, the need of rescue analgesia resulted significantly higher in the control group (p = 0.03). This is the first study showing that TAP block could be employed as an effective and feasible anesthesia method for the retroperitoneal varicocelectomy. Moreover, our results demonstrate that this method is more effective than spinal anesthesia in the pain control after varicocele repair.

- Hsu GL, Ling PY, Hsieh CH et al (2005): Outpatient varicocelectomy performed under local anesthesia. Asian J Androl 7(4):439–444.
2-Charlton S, Cyna AM, Middleton P et al (2010) :Perioperative transversus abdominis plane (TAP) blocks for analgesia after abdominal surgery. Cochrane Database of Systematic Reviews, vol 8, Article ID CD007705.
3-Rafi N (2001) Abdominal field block: a new approach via the lumbar triangle. Anaesthesia 56(10):1024–1026.
4-Kearns RJ, Young SJ (2011) :Transversus abdominis plane blocks; a national survey of techniques used by UK obstetric anaesthetists. Int J Obstet Anesth 20(1):103–104.
5-Rozen WM, Tran TM, Ashton MW et al (2008): Refining the course of the thoracolumbar nerves: a new understanding of the innervation of the anterior abdominal wall. Clin Anat 21(4):325–333.
6-McDonnell JG, O’Donnell BD, Farrell T et al (2007) Transversus abdominis plane block: a cadaveric and radiological evaluation. Reg Anesth Pain Med 32(5):399–404.
7-Tran TM, Ivanusic JJ, Hebbard P et al (2009): Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study. Br J Anaesth 102(1):123–127.
8-McDonnell JG, O’Donnell B, Curley G et al (2007): The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg 104:193–197.
9-Rafi AN (2001) Abdominal field block: a new approach via the lumbar triangle. Anaesthesia 56:1024–1026.
10-Hebbard P, Fujiwara Y, Shibata Y et al (2007) Ultrasound-guided transversus abdominis plane (TAP) block. Anaesth Intensive Care 35:616–617.
11-Suresh S, Chan VW (2009): Ultrasound guided transversus abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance. Paediatr Anaesth 19:296–299.
12-Farooq M, Carey M (2008) A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med 33:274–275.
13-McDermott G, Korba E, Mata U et al (2012) :Should we stop doing blind transversus abdominis plane blocks? Br J Anaesth 108(3):499–502.
14-O’Donnell BD, McDonnell JG, McShane AG (2006):The transversus abdominis plane (TAP) block in open retropubic prostatectomy. Reg Anesth Pain Med 31:91.
15-Carney J, McDonnell JG, Ochana A, Bhinder R (2008): The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg 107(6):2056–2060.
16-McDonnell JG, Curley G, Carney J et al (2008) :The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg 106(1):186–191.
17-McMorrow RC, Ni Mhuircheartaigh RJ, Ahmed KA et al (2011): Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section. Br J Anaesth 106(5):706–712.