Transplant Trial Watch

Comparison of Three-Quadrant Transversus Abdominis Plane Block and Continuous Epidural Block for Postoperative Analgesia After Transperitoneal Laparoscopic Nephrectomy.

Aditianingsih D, Mochtar CA, et al.

Anesth. 2018; 8(5):e80024.

To compare the effect of TAP block analgesia with continuous epidural analgesia for pain management following transperitoneal laparoscopic living donor nephrectomy.

Three-quadrant TAP block using 0.25% bupivacaine with additional dexamethasone 8 mg versus continuous epidural block using 0.125% bupivacaine.

50 adult patients under going transperitoneal laparoscopic living donor nephrectomy (TAP block, n=25; continuous epidural, n=25).

Outcomes assessed in ITT population. The primary outcome was cumulative morphine consumption in the first 24 hours after surgery. The secondary outcomes were the numerical rating scale (NRS) assessment of pain, the first-time mobilization, and duration of urinary catheterization, postoperatively.

24 hours post surgery

CET Conclusions
The primary outcome was morphine consumption in the first 24 hours after surgery. It is likely that this study was underpowered for this outcome and no power calculation is presented. There was no significant difference in the amount of morphine used post-operatively. There were no significant differences between the groups in terms of pain scores and time to mobilisation. There was a significantly longer duration of urinary catheterisation in the epidural group. Despite being described as a randomised study, there is no description of the method used, and we therefore cannot comment on its adequacy, or whether or not allocation concealment was possible. In its favour the study was strictly intention to treat analysis and there were no patients lost to follow up.

Jadad score

Data analysis
Strict intention-to-treat analysis

Allocation concealment

Trial registration - NCT03154436

Funding source
Non-industry funded