Transversus Abdominus Plane Block

Ultrasound Guided Transversus Abdominus Plane Block for Patients Undergoing Laparoscopic Hand-assisted Nephrectomy.

Transversus Abdominus Plane (TAP) block may reduce need for postoperative pain medications in patients undergoing laparoscopic hand assisted nephrectomy. Our hypothesis is that the TAP block will result in a significant reduction in pain scores and morphine requirements in the active group.

Inclusion Criteria:

• Patients who are ≥ 18 and ≤ 80 years of age.
• Patients scheduled to undergo hand assisted laparoscopic removal of a single kidney for either tumor or living donor transplantation.

Exclusion Criteria:

• Patients scheduled to undergo an open procedure for nephrectomy
• Patients who are converted from hand assisted laparoscopic surgery to open surgery due to intraoperative complications.
• Bilateral nephrectomy
• Pregnant or lactating patients
• Patients unable or unwilling to provide informed consent
• Patients unable to comprehend the use of a visual analog scale
• Patients desiring preemptive antiemetics
• Opioid tolerance
• Allergy to amide local anesthetics or any of the study drugs (morphine).
• Contraindication to regional nerve block (bleeding disorder, infection at site of block)
• Patients with history of dementia