1. Continuous Transverse abdominis plane block vs thoracic epidural anesthesia in radical cystectomy under a enhanced recovery after surgery program: preliminar results
Casans Francés R, Roberto Alcácer AT, Ferrer Ferrer ML, Pérez Pascual LI, García Lecina AC, Aleson Horno G, Ruíz Garcés T, Guillén Antón J.
Department of Anesthesiology, Hospital Clínico Universitario “Lozano Blesa”, Zaragoza, Spain

2. Methods
Retrospective analysis of a prospective cohort of patients undergoing ERAS radical cystectomy (according to ERAS society guidelines)
A Continuous TAP Block (Levobupivacaíne 0.1% - 8 ml/H by side) was implemented in patients who were not able to implement a thoracic epidural catheter (3 attempts in different intervertebral spaces or 20 minutes)
Morbidity and mortality, infunded fluid, hemodynamic variables and analgesia quality were compared.

3. Charlson’s comorbidity index
Analgesia 25% Median 75%
Epidural
TAP
Charlson’s comorbidity index
Wilconson’s
P-value =

5. Outcome
Analgesia
Q25
Median
Q75
Wilconson p-value
Lenght of Stay
Epidural 9 12
0.1318
TAP
11.5
17.5
31.5
Critical Care LoS 1
1.17 2
0.1934
1.0525
1.31
2.7875
Time under Mechanical Ventilation
270
301
346.5
0.2805
280.25
340
357.5

6. Analgesia
Q25
Median
Q75
Wilcoxon’s p
24 h VAS
Epidural 2 3 4
0.168
TAP 1
48 h VAS
1.75
2.5
3.25
0.816
3.5

7. Intraoperative bleeding

8. Intraoperative fluidtherapy

9. Blood products

10. Noradrenaline

11. Remifentanyl

12. Mean Arterial Pressure

13. Systolic volume

14. Cardiac Index

15. Peak Velocity

16. Corrected Flux Time

17. Conclusions
No differences in VAS score were found between thoracic epidural and continuous TAP block
TAP block group needed significative more use of nasogastric tube during postoperative period.
Increased complications and hospital stay was detected in TAP block group, but not statistically significant.
Although both groups had similar needs of intraoperative drugs and fluids, epidural group B had better cardiac profile, cardiac output and systolic volume.