Analgesia by Transversus Abdominis Plane Nerve Block in Patients Undergoing Liver Resection.

Analgesia by Transversus Abdominis Plane Nerve Block in Patients Undergoing Liver Resection

The indications liver cancer surgery currently booming due to the increase in surgical techniques and instruments for a more secure resection of liver tissue with a significant reduction in bleeding or surgical complications. This allowed to expand surgical indications in the most fragile patients so assuming optimized anesthetic care.

So far, the technique of analgesia reference to this surgery remains administration of morphine analgesia via a device controlled by the patient (PCA) for epidural analgesia is against-indicated because of induced bleeding disorders by surgery.

Rafi then McDonnell in 2007 have described a new technique of loco regional anesthesia, the abdomen of the Transversus Abdominis Plane (TAP) nerve block(TAP), which allows selective anesthesia of the abdominal wall. But parietal pain related muscular and nervous sagging surgical approach represent a significant share of post operative pain.

This study proposes an evaluation of the abdomen transverse blocks in hepatectomy.

Inclusion Criteria:

• hepatectomy or segmentectomy

Exclusion Criteria:

• Sepsis uncontrolled current
• Overdose in anticoagulant during general anesthesia
• Thrombocytopenia <50 g / dl
• Severe renal impairment: Cockcroft <30 ml / min
• history of ventricular arrhythmia serious unexplained .*
• Allergy to local anesthetics of the amide
• Contraindication to remifentanil and morphine
• Hypovolemia