DOI: 10.1097/bn9.0000000000000123 ISSN: 3066-8905

Transversus Abdominis Plane (TAP) Block Prior to Minimally Invasive Anterior Lumbar Interbody Fusion (MIS-ALIF) Decreases Opioid Consumption and Hospital Length of Stay

Drashti A. Upadhyay, Samuel J. Mosiman, Kayla N. Bradburn, Clifford B. Tribus, Miranda J. Bice, James T. Bernatz, Seth K. Williams
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Study Design:

A retrospective cohort analysis of 235 patients who underwent MIS-ALIF between 2014 and 2024 at a single institution.

Objective:

To evaluate the effect of preoperative transversus abdominis plane (TAP) block on postoperative opioid consumption, postoperative pain, and hospital length of stay in patients undergoing ALIF.

Summary of Background Data:

A TAP block is a regional anesthetic technique increasingly used for postoperative pain control in select abdominal procedures. Recent literature has reported a proposed benefit of using preoperative TAP blocks before anterior lumbar interbody fusion (ALIF) procedures.

Materials and Methods:

The control group consisted of 157 patients who did not undergo a TAP block. The experimental group included 78 patients who underwent ALIF with a preoperative TAP block using liposomal bupivacaine. The effects of preoperative TAP blocks on patients undergoing an ALIF were evaluated with respect to postoperative opioid consumption, postoperative pain, and hospital length of stay (LOS).

Results:

The TAP block group experienced an overall shorter length of stay (28.4 vs. 48.6 h, P <0.001) and PACU arrival to discharge (15.4 vs. 33.7 h, P <0.001). The TAP block group also consumed fewer inpatient opioids (14.3 vs. 37.5 MME, P <0.001) and fewer outpatient opioid prescription quantities (270.3 vs. 368.5 MME, P <0.001). There were no statistically significant differences between the TAP block group and the control group when comparing NRS pain scores at rest, but there was a statistically significant decrease in NRS pain with activity (5.5 vs. 6, P =0.0439).

Conclusions:

Patients undergoing ALIF with a preoperative TAP block demonstrated statistically significant decreases in in-hospital LOS, inpatient opioid consumption, and outpatient opioid prescriptions, without an increase in reported postoperative pain. These results suggest that a preoperative TAP block may be beneficial as part of a comprehensive perioperative pain plan regimen for patients undergoing ALIF.

Levels of Evidence

Level III—per Oxford Center for Evidence-Based Medicine Table.

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