Integrating the Transversus Abdominis Plane Block into an ERAS Protocol for Bariatric Surgery Patients

Abstract

This Doctor of Nursing Practice (DNP) project investigates the integration of the Transversus Abdominis Plane (TAP) block into Enhanced Recovery After Surgery (ERAS) guidelines for bariatric surgery patients, aiming to improve postoperative outcomes by reducing opioid consumption, time to ambulation, and hospital length of stay (LOS). Bariatric patients who undergo sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) frequently encounter challenges with postoperative pain, increasing opioid use, delaying postoperative time to ambulation, and increasing postoperative hospital LOS. Prolonged postoperative hospitalization increases the financial impact on the healthcare system, and bariatric patients who have a longer postoperative LOS have a higher rate of readmission. While the TAP block has shown promise in enhancing postoperative analgesia and reducing reliance on opioids, it remains underutilized in clinical settings. This DNP project utilizes the Iowa Model of Evidence-Based Practice to guide the development, pilot implementation, and hospital-wide adoption of the TAP block within an ERAS guideline for bariatric patients. A multidisciplinary team has designed and implemented an intervention that could be evaluated by incorporating a small-scale pilot study to evaluate its impact on patient outcomes. The anticipated outcomes include a 20% reduction in opioid use, earlier ambulation, and shorter LOS, contributing to improved patient satisfaction and decreased healthcare costs. This proposed project can potentially standardize the TAP block as an integral part of and ERAS guideline, enhancing recovery for bariatric surgery patients in rural community hospitals