Effect of transversus abdominis plane blocks in abdominoplasties on postoperative outcomes

TL;DR

Using a transversus abdominis plane block during abdominoplasty reduces hospital stay, complications, and medication use, improving recovery outcomes.

Contribution

This study is the first to demonstrate the effectiveness of TAP blocks in abdominoplasty, a procedure where their use was previously underexplored.

Findings

TAP block reduced hospital stay by 2.21 days after adjusting for confounders.

TAP block lowered overall complication risk by 52%, especially reducing haematoma occurrence.

Patients with TAP block required less postoperative medication, including lower doses of tilidine and metamizole.

Abstract

Acute postoperative pain after surgery may lead to significant complications including chronification of pain, impaired cardiopulmonary function, and increased healthcare costs. As a common and complex procedure, abdominoplasty is a key focus for pain management strategies. Although transversus abdominis plane blocks, which target the abdominal wall's sensory nerves to reduce postoperative pain by blocking nociceptive input, have shown promise in reducing postoperative pain in abdominal surgeries, their use in abdominoplasty remains underexplored.

Outcomes for patients undergoing abdominoplasty between 2013 and 2024 were analysed, comparing those who received a transversus abdominis plane block with those who did not. Postoperative analgesia followed a standardized protocol using oral narcotics and piritramide. Pain outcomes were assessed in both groups via chart review. The primary outcome, length of hospital stay, was analysed by multivariable linear regression adjusted for patient and surgical factors. Secondary outcomes, including complications and revision rates, were assessed by logistic regression. Exploratory analyses examined how reductions in medication use affected length of hospital stay and discharge timing.

Overall, 192 patients who had an abdominoplasty were included in analyses: 93 had a transversus abdominis plane block and 99 did not. The transversus abdominis plane group had a significantly shorter hospital stay, with a reduction of 2.21 (95% confidence interval (c.i.) −3.07 to −1.36) days after adjusting for confounders (P < 0.001; effect size, Cohen's d 0.45). Surgical complications occurred in 46.9% of patients. The overall complication risk in the transversus abdominis plane block group was significantly reduced by 52% (adjusted odds ratio 0.44, 95% c.i. 0.23 to 0.84; P = 0.012; effect size 0.52), particularly the occurrence of haematoma (adjusted odds ratio 0.34; P = 0.031; effect size 0.66). Additionally, patients who had a transversus abdominis plane block required less postoperative medication, including lower tilidine (P = 0.038) and metamizole (P = 0.032) doses.

Use of the transversus abdominis plane block in patients who had an abdominoplasty was associated with improved postoperative outcomes, highlighting its potential as an effective pain management strategy and supporting its broader clinical application.

This retrospective cohort study evaluated the impact of the transversus abdominis plane (TAP) block on postoperative outcomes in patients who had an abdominoplasty. The results showed that the TAP block significantly reduces length of hospital stay, lowers complication rates, including that of haematoma, and decreases postoperative medication use. These findings suggest that the TAP block is an effective regional anaesthesia technique for improving recovery after abdominoplasty procedures.

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