"Feasibility and Postoperative Analgesia of Transversus Abdominis Plane Block in Patients Undergoing Total Abdominal Hysterectomy"
Journal of Anesthesia & Intensive Care Medicine
The transversus abdominis plane (TAP) block is a regional anaesthetic technique that provides postoperative analgesia after abdominal surgery. This study was done to evaluate its feasibility and its efficacy on postoperative analgesia in patients undergoing total abdominal hysterectomy in a resource-limited setting. Methods: Ninety women, aged 30 to 68 years, classified ASA I and II, proposed for total abdominal hysterectomy indicated for uterine fibroids, were divided into two groups by
... wo groups by randomization. Group A received a blind bilateral TAP block with ropivacaïne (1.5 mg/kg on each side) and after installation of sensory block, the general anaesthesia was carried out with propofol, fentanyl, rocuronium and isoflurane. Group B received only general anaesthesia with the same protocol like in group A. The success rate of TAP block was recorded in group A. In both groups, postoperative pain scores at rest, coughing efforts and postoperative analgesic consumption have been compared. Results: In Group A, the success rate of blind TAP block was 95.5 %. At the complete awakening of the patients, the mean visual analogue scale scores were significantly lower in patients in Group A compared to the patients in Group B (at rest 10.46 ± 0.92 versus 32.05 ± 20.81 mm, p=0.006 and with coughing 23.61 ± 12.04 versus 41.25 ± 18.50 mm, p=0.009). Compared to women in Group B, those in Group A had significantly lower visual analogue scale scores at rest, coughed less during the first 48 hours postoperatively and consumed significantly less ketoprofen (176.47 ± 65.40 mg versus 300.00 ± 41.40 mg, p =0.000) and no morphine (0 mg versus 15.19 ± 3.6, p=0.000). Conclusion: In a resource-limited setting, blind TAP block is feasible and should be practiced because it is easy to achieve. It significantly decreases postoperative pain and reduces the requirement for opioids and other analgesics.