Association of Transversus Abdominis Plane Block (TAPB) with Postoperative Delirium (POD) in Elderly Patients Undergoing Major Gastrointestinal Surgery

Association of Transversus Abdominis Plane Block (TAPB) with Postoperative Delirium (POD) in Elderly Patients Undergoing Major Gastrointestinal Surgery: a Retrospective Cohort Study

Postoperative delirium can increase postoperative adverse reactions and prognosis in elderly patients undergoing gastrointestinal surgery. This study studied the effects of ultrasound-guided transversal plane block on postoperative delirium, opioid consumption and prognosis in elderly patients undergoing gastrointestinal surgery, comprehensively evaluated the effectiveness and safety of TAPB, and evaluated its clinical value.

Study Overview

• Status: Completed
• Conditions: Postoperative Delirium (POD); Regional Anaesthesia; Transversus Abdominis Plane Block (TAP Block)

Detailed Description

Postoperative delirium (POD) is a common neurocognitive disorder in elderly patients after surgery, which is characterized by attention deficit, memory impairment and confusion, usually occurring within one week after surgery. It occurs in 11%-51% of elderly patients undergoing gastrointestinal surgery and is associated with long-term poor prognosis such as dementia and increased mortality. Risk factors include advanced age, high ASA grade, hypoalbuminemia, and prolonged anesthesia. Regional nerve block (NBs), as the core means of multimodal analgesia, has been shown to reduce the incidence of POD in orthopedic and thoracic surgery by reducing opioid use and stress response, but its effect in elderly gastrointestinal surgery still needs to be further explored. Transverse abdominal muscle plane block (TAPB) is a commonly used technique in abdominal surgery. It can effectively control pain and reduce inflammation and stress response by blocking sensory nerves in the abdominal wall. This study focused on the effect of TAPB on POD in elderly patients undergoing major gastrointestinal surgery, aiming to provide evidence-based evidence for optimizing perioperative anesthesia management.

• Study Type: Observational
• Enrollment (Actual): 5220

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All perioperative data required for this study were obtained from patients at the First Medical Center of the Chinese PLA General Hospital from January 2016 to March 2022.

Description

Inclusion Criteria:

1. age ≥65 years;
2. major gastrointestinal surgery, defined as procedures lasting more than one hour and involving partial resection of the stomach or intestines;
3. general anesthesia with endotracheal intubation.

Exclusion Criteria:

1. emergency surgeries;
2. transanal endoscopic microsurgery (TEM);
3. patients with a history of preoperative delirium, altered consciousness, or psychiatric conditions, such as epilepsy, Alzheimer's disease, Parkinson's disease, schizophrenia, and anxiety or depressive disorders, as well as encephalopathies (hepatic, pulmonary, and renal) and hydrocephalus, along with those experiencing significant preoperative visual or auditory impairments;
4. patients who died within 24 h postoperatively or missing data of >50% in their medical records.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
TAPB group and non-TAPB group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
POD incidence within 7 days postoperatively	within 7 days postoperatively

Secondary Outcome Measures

Outcome Measure	Time Frame
intraoperative sufentanil dosage	intraoperative
length of hospital stay	no more than 1 year
mortality	30 day after the surgery

Collaborators and Investigators

• Sponsor: Chinese PLA General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2016
• Primary Completion (Actual): March 31, 2022
• Study Completion (Actual): October 12, 2024

Study Registration Dates

• First Submitted: February 11, 2025
• First Submitted That Met QC Criteria: February 14, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 14, 2025
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Keywords: Regional Anaesthesia; Transversus abdominis plane block (TAP block); Postoperative Delirium (POD)
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Mental Disorders; Postoperative Complications; Pathologic Processes; Confusion; Neurobehavioral Manifestations; Neurocognitive Disorders; Emergence Delirium; Delirium
• Other Study ID Numbers: PLAGH-TAPB-001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No