Single-shot TAP Block vs Continuous TAP Block

This study is a randomized, prospective, double blind study comparing single shot versus
continuous transversus abdominis plane (TAP) block for postoperative analgesia after
laparoscopic live donor nephrectomy.

Good pain control after surgery has been shown to decrease complications. To address the
problem of postoperative pain control in donor nephrectomy patients,the study investigators
began performing Transversus Abdominis Plane (TAP) blocks. The TAP block involves injection
of local anesthetic between the abdominal muscle planes (internal oblique muscle and
transversus abdominis muscle), to block the somatic nerves that supply sensation to the
skin, muscles, and parietal peritoneum of the anterior abdominal wall. Prior reports of TAP
blocks have shown that it provides good analgesia for postoperative pain after abdominal
surgery. However because the duration of postoperative pain exceeds that of the single shot
TAP block, the investigators hypothesized that by placing a catheter through which a
continuous infusion of local anesthetic could be delivered, investigators could provide
analgesia throughout the postoperative period. The study investigators also hypothesized
that improved analgesia would decrease the need for opioid pain medications, hence
decreasing the side effects associated with opioid use.

This study is designed to test our hypothesis that placing a TAP catheter is superior to
single shot TAP, because it provides a longer duration of analgesia and decreases narcotic
use.

Inclusion criteria:

- Healthy subject undergoing laparoscopic live donor nephrectomy

- (ASA) American Society of Anesthesiologists class 1 or 2

- Age 18 or older, male or female

- Desires TAP block for postoperative pain control

Exclusion criteria:

- Any contraindication for TAP block - single or continuous

- History of substance abuse

- Any physical, mental or medical conditions which, in the opinion of the
investigators, may confound quantifying postoperative pain resulting from surgery.

- Known allergy or other contraindications to the study medications (Ropivacaine,
Normal Saline, Hydromorphone, Oxycodone and Acetaminophen)