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BACKGROUND: Enhanced recovery pathways (ERP) have been well shown to permit early recovery and discharge. The addition of a transversus abdominis plane (TAP) block to a standard pathway may improve these outcomes. We evaluated the addition of a TAP block to an established ERP. STUDY DESIGN: One hundred consecutive patients underwent elective laparoscopic colectomy by a single surgeon. A laparoscopic-guided TAP block was administered at the end of the procedure. Patients followed an established ERP that included overnight intravenous patient-controlled analgesia pump, diet and oral analgesia on postoperative day 1, and standardized discharge criteria. RESULTS: The mean age was 60.5 years (range 15 to 92 years), 62 patients were female, and mean body mass index was 28.4 kg/m(2) (range 18 to 46 kg/m(2)). Median hospital stay was 2 days and mean length of stay was 2.9 days. Patients were grouped and analyzed by the day of discharge. Sixty-two percent of patients were discharged within 48 hours (27 on day 1; 35 on day 2). There was no mortality. Only 1 patient discharged within 48 hours of surgery developed a complication. Two patients were readmitted, both of whom were discharged more than 48 hours after surgery. CONCLUSIONS: Transversus abdominis plane blocks with an ERP contribute to a short length of stay after laparoscopic colectomy, without increasing complication or readmission rates.
Favuzza et al. (Fri,) studied this question.