A Comparative Study between Ultrasound Guided Trans-muscular Quadratus Lumborum Block Versus Ultrasound Guided Transversus Abdominis Plane Block as postoperative analgesia in Laparoscopic Bariatric Surgery

Abstract Background A variety of unwanted post-operative consequences, including patient suffering, respiratory distress complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain are due to poorly controlled acute pain after laparoscopic abdominal surgery. Aim of the Work is to compare the analgesic efficacy of ultrasound-guided TQL with TAP block during laparoscopic bariatric surgery and to improve the outcome of the patients undergoing laparoscopic bariatric surgery under general anesthesia who suffer from postoperative pain and also in the early postoperative period regarding pain relief, decreasing postoperative opioid requirements, provision of comfort, early mobilization and improved respiratory functions. Patients and Methods The study was conducted on 40 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 20 patients each: Group TQL (n = 20): received combined general anesthesia with TQL block. Group TAP (n = 20): received combined general anesthesia with TAP block. Results TQL block has more analgesic efficacy than TAP block. The first call for rescue analgesia (Meperidine), total meperidine consumption and pain scores (visual analog score at rest and movement) indicated the superiority of the analgesic technique TQL block. Conclusion TQL with general anesthesia was more effective technique in providing analgesia after laparoscopic bariatric surgery without associated hemodynamic instability in comparison to TAP block with general anesthesia and also the first call for rescue analgesia (Meperidine), total meperidine consumption and pain scores (visual analog score at rest and movement) indicated the superiority of the analgesic technique TQL block.

Download Full-text

Comparison between Ultrasound Guided Transversus Abdominis Plane Block versus Ultrasound Guided IlioInguinal/Iliohypogastric Nerves Block for Postoperative Analgesia in Patients Undergoing Unilateral Oblique Inguinal Hernia Repair Under General Anesthesia

QJM ◽

10.1093/qjmed/hcab086.106 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Shrouk Ayman Mohamed Soliman Faramawy ◽

Samia Abdel-Mohsen Abdel-Latif ◽

Mohamed Abdel-Salam Menshawe Abdel-Atte ◽

Ibrahim Mohammed El Sayed Ahmed

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

General Anesthesia ◽

Inguinal Hernia Repair ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Rescue Analgesia ◽

Pain Scores

Abstract Background Inguinal hernia considered the third common disease in surgeries for adults after acute appendicitis and proctologic disorders. About 20 millions of inguinal hernia repairs are performed globally. Inguinal herniorrhaphy is frequently associated with persistent postoperative pain. Objectives The aim of this study is to assess the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared to ilioinguinal/iliohypogastric nerves block after unilateral inguinal hernia repair regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received. Patients and Methods The study was conducted on 70 randomly chosen patients aged 21 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia, in Ain Shams University Hospitals after approval of the medical ethical committee. Results The results of the study revealed that there is Patients receiving TAP block had significantly lower pain scores at 4 h and 6 h after operation, delay time for rescue analgesia and decrease total need of analgesic in first 24 h post operative compared with patients who received ilioinguinal/ iliohypogastric nerves block. Conclusion TAP block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to ilioinguinal/iliohypogastric nerves block. This technique can be a promising mode of postoperative analgesia when epidural catheter insertion is contraindicated.

Download Full-text

Bilateral ultrasound-guided abdominal peripheral block in tap plane, tap - block

Trakia Journal of Sciences ◽

10.15547/tjs.2020.04.009 ◽

2020 ◽

Vol 18 (4) ◽

pp. 344-349

Author(s):

M. Sekulovski ◽

B. Simonska ◽

G. Mutafov ◽

V. Alexandrov ◽

L. Spassov

Keyword(s):

General Anesthesia ◽

Analgesic Efficacy ◽

Opioid Analgesics ◽

Abdominal Muscle ◽

Control Group ◽

Tap Block ◽

Ultrasound Guided ◽

Group I ◽

Group Ii ◽

Peripheral Block

INTRODUCTION: Bilateral ultrasound-guided peripheral block (TAP - block) in the plane between the inner oblique abdominal muscle and the transversal abdominal muscle – TAP plane, is a regional anesthesia technique by infiltration of a local anesthetic, provides analgesia for operations involving the anterior abdominal wall. The analgesic effectiveness of the block decreases the consumption of opioid analgesics and non-steroidal anti-inflammatory drugs. AIM: In this study, we evaluated the intraoperative analgesic efficacy of bilateral TAP - block and the consumption of opioid analgesics in patients undergoing bilateral laparoscopic inguinal hernia repair. METHODS: The study was conducted with 35 patients, who were randomized into two groups. In the control group (group I), there are patients who received general anesthesia (GA), and experimental group (group II), were patients who have received general anesthesia and a bilateral tap block (GA + TAP). RESULTS: Patients with TAP-block (group II) have significantly lower fentanyl consumption compared to group I. CONCLUSION: Multimodal approach for the simultaneous administration of general anesthesia with a TAP block provides effective intraoperative analgesia and significantly reduces the perioperative consumption of opioid analgesics.

Download Full-text

Transversus Abdominis Plane (TAP) Block: A Comparative Study between Levobupivacaine versus Levobupivacaine plus Ketamine in Abdominoplasty

Pain Research and Management ◽

10.1155/2021/1762853 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Radwa F. Mansour ◽

Mohamed A. Afifi ◽

Mohamed S. Abdelghany

Keyword(s):

Visual Analogue Scale ◽

Prospective Study ◽

Analogue Scale ◽

Analgesic Efficacy ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Rescue Analgesia ◽

Prolonged Duration

Purpose. We conducted this study to explore the hypothesis that the addition of ketamine to levobupivacaine in ultrasound-guided Transversus Abdominis Plane (TAP) block would result in a better and prolonged duration of postoperative analgesia for patients undergoing abdominoplasty. Material and Methods. This randomized prospective study was conducted on 50 patients who were scheduled for abdominoplasty. TAP block was performed bilaterally for all patients either with levobupivacaine 0.5% 15 ml plus ketamine 0.5 mg/kg in a total volume of 20 ml in the LK group (n = 25) or with levobupivacaine 0.5% 15 ml plus 5 ml normal saline in a total volume of 20 ml in the L group on each side. Results. Visual analogue scale (VAS) was significantly lower in the LK group in resting condition at 6, 12, and 16 h postoperatively compared to the L group. On movement, the VAS was significantly lower at 4, 6, 8, 12, 16, and 24 h postoperatively in the LK group compared to the L group. The time for first rescue analgesia was longer in the LK group (18.7 ± 4.8 h) than that in the L group (6.5 ± 2.4 h) with the reduced total amount of rescue morphine in the LK group (1.14 ± 2.2 mg) versus the L group (5.86 ± 3.6 mg). Only six patients in the LK group requested rescue morphine, whereas nineteen patients requested rescue morphine in the L group. Conclusions. In TAP block, adding ketamine 0.5 mg/kg enhanced the analgesic efficacy of levobupivacaine 0.5% in patients undergoing abdominoplasty and reduced the required analgesics postoperatively.

Download Full-text

A Comparative Study between Ultrasound Guided Bilateral Transversus Abdominis Plane block Versus Opioids (Nalbuphine) Analgesia after Abdominoplasty

QJM ◽

10.1093/qjmed/hcab086.032 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Omar Mohammed Taha Elsafty ◽

Hanan Mahmoud Farag Awad ◽

Mostafa Gamal Eldin Mahran ◽

Haidy Atef Fekry Sadek

Keyword(s):

Single Injection ◽

Safety Margin ◽

Analgesic Efficacy ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

University Hospitals ◽

Rescue Analgesia ◽

Prolonged Hospital

Abstract Background Poorly controlled acute pain after abdominoplasty is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and an increased likelihood of chronic pain. Objectives The aim of this study is to assess the analgesic efficacy and hemodynamic effects of bilateral ultrasound guided single injection Transversus Abdominis Plane (TAP) Block compared with intravenous nalbuphine after abdominoplasty. Each of them combined with general anesthesia in patients undergoing abdominoplasty. Patients and Methods The study was conducted on 70 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 35 patients each: Group TAP: bilateral ultrasound guided TAP block was performed before extubation of patients using 20 ml of 0.25% bupivacaine in each side, Group N: received intravenous nalbuphine as post operative analgesia after abdominoplasty. Results The results of the study revealed that single injection tansversus abdominis plane block has more analgesic efficacy than intravenous nalbuphine. The first call for rescue analgesia (nalbuphine), total nalbuphine consumption and pain scores (visual analog score) indicated that the superiority of the analgesic technique (TAP Block) was attributed to their opioid sparing effect. Conclusion An ultrasound-guided TAP block technique allows for direct visualization of all anatomical structures, the needle, and the spread of local anesthetic, thereby increasing the safety margin, optimizing block qualities, decreasing systemic analgesia requirements and sparing its side effects.

Download Full-text

P29: TRANSVERSUS ABDOMINIS PLANE BLOCK IN LAPAROSCOPIC BARIATRIC SURGERY- A SYSTEMATIC REVIEW AND META ANALYSIS OF RANDOMISED CONTROLLED TRIALS

British Journal of Surgery ◽

10.1093/bjs/znab117.114 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

A Aamir ◽

SM Sahebally ◽

HM Heneghan

Keyword(s):

Bariatric Surgery ◽

Meta Analysis ◽

Mean Difference ◽

Transversus Abdominis ◽

Laparoscopic Bariatric Surgery ◽

Complication Rates ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Pain Scores ◽

Randomised Controlled

Abstract Introduction Effective postoperative analgesia is paramount in the management of patients undergoing bariatric surgery, given their increased predisposition to systemic narcotic-induced respiratory depression. Transversus abdominis plane (TAP) block has shown promise in the enhanced recovery pathway for several abdominal procedures. We performed a systematic review and meta-analysis to compare the effectiveness of TAP block in laparoscopic bariatric surgery. Method PubMed, EMBASE and Cochrane databases were searched for relevant articles from inception until November 2019. All trials that compared TAP blocks versus none in laparoscopic bariatric procedures were included. The primary outcome measure was narcotic consumption at 24 hours postoperatively, while secondary outcomes included pain scores, time to ambulation, postoperative nausea and vomiting (PONV) and complication rates. Random effects models were used to calculate pooled effect size estimates. Result Seven randomised controlled trials were included capturing 617 patients. There was high statistical heterogeneity across studies. On random effects analysis, there were no significant differences in narcotic consumption (Mean difference –18.4 mg, 95% CI=-38.7 to 1.91, p=0.08), pain scores (Mean difference -0.71, 95% CI=-1.93 to 0.50, p=0.25) or complications (OR=0.67, 95% CI=0.11 to 4.23, p=0.67) between TAP and no TAP groups. However, TAP was associated with significantly less time to ambulation (Mean difference -2.22 hours, 95% CI=-3.89 to -0.56, p=0.009), and PONV (OR=0.13, 95% CI=0.05 to 0.35, p<0.0001) rates. Conclusion TAP in laparoscopic bariatric surgery is associated with significantly less PONV and time to ambulation but similar narcotic usage, postoperative pain and complication rates, compared to no TAP. Take-home message TAP in laparoscopic bariatric surgery is associated with a shorter time to ambulation and less PONV but similar postoperative pain and narcotic usage, compared to no TAP.

Download Full-text

Transversus abdominis Plane Block for Improved Early Postoperative Pain Management after Periacetabular Osteotomy: A Randomized Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm10030394 ◽

2021 ◽

Vol 10 (3) ◽

pp. 394

Author(s):

Jannis Löchel ◽

Viktor Janz ◽

Vincent Justus Leopold ◽

Michael Krämer ◽

Georgi I. Wassilew

Keyword(s):

Postoperative Pain ◽

Periacetabular Osteotomy ◽

Opioid Consumption ◽

Transversus Abdominis ◽

Control Group ◽

Block Group ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Pain Scores

Background: Patients undergoing periacetabular osteotomy (PAO) may experience significant postoperative pain due to the extensive approach and multiple osteotomies. The aim of this study was to assess the efficacy of the transversus abdominis plane (TAP) block on reducing opioid consumption and improving clinical outcome in PAO patients. Patients and Methods: We conducted a two-group randomized-controlled trial in 42 consecutive patients undergoing a PAO for symptomatic developmental dysplasia of the hip (DDH). The study group received an ultrasound-guided TAP block with 20 mL of 0.75% ropivacaine prior to surgery. The control group did not receive a TAP block. All patients received a multimodal analgesia with nonsteroidal anti-inflammatory drugs (NSAID) (etoricoxib and metamizole) and an intravenous patient-controlled analgesia (PCA) with piritramide (1.5 mg bolus, 10 min lockout-time). The primary endpoint was opioid consumption within 48 h after surgery. Secondary endpoints were pain scores, assessment of postoperative nausea and vomiting (PONV), measurement of the quality of recovery using patient-reported outcome measure and length of hospital stay. Forty-one patients (n = 21 TAP block group, n = 20 control group) completed the study, per protocol. One patient was lost to follow-up. Thirty-three were women (88.5%) and eight men (19.5%). The mean age at the time of surgery was 28 years (18–43, SD ± 7.4). All TAP blocks were performed by an experienced senior anaesthesiologist and all operations were performed by a single, high volume surgeon. Results: The opioid consumption in the TAP block group was significantly lower compared to the control group at 6 (3 mg ± 2.8 vs. 10.8 mg ± 5.6, p < 0.0001), 24 (18.4 ± 16.2 vs. 30.8 ± 16.4, p = 0.01) and 48 h (29.1 mg ± 30.7 vs. 54.7 ± 29.6, p = 0.04) after surgery. Pain scores were significantly reduced in the TAP block group at 24 h after surgery. There were no other differences in secondary outcome parameters. No perioperative complication occurred in either group. Conclusion: Ultrasound-guided TAP block significantly reduces the perioperative opioid consumption in patients undergoing PAO.

Download Full-text

Randomised clinical trial comparing the perioperative analgesic efficacy of oral tramadol and intramuscular tramadol in cats

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x211040406 ◽

2021 ◽

pp. 1098612X2110404

Author(s):

Sébastien H Bauquier

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Analgesic Efficacy ◽

Randomised Clinical Trial ◽

Rescue Analgesia ◽

Exact Test ◽

Pain Scores ◽

Significant Difference ◽

American Society ◽

Induction Of Anaesthesia

Objectives The aim of this study was to evaluate the analgesic efficacy of oral tramadol in cats undergoing ovariohysterectomy. Methods Twenty-four female domestic cats, American Society of Anesthesiologists class I, aged 4–24 months, were included in this positive controlled, randomised, blinded clinical trial. Cats admitted for ovariohysterectomy were allocated to group oral tramadol (GOT, n = 12) or group intramuscular tramadol (GIMT, n = 12). In GOT, tramadol (6 mg/kg) was given orally 60 mins, and saline was given intramuscularly 30 mins, before induction of anaesthesia. In GIMT, granulated sugar in capsules was given orally 60 mins and tramadol (4 mg/kg) intramuscularly 30 mins before induction of anaesthesia. In both groups, dexmedetomidine (0.007 mg/kg) was given intramuscularly 30 mins before induction of anaesthesia with intravenous propofol. Anaesthesia was maintained with isoflurane in oxygen, and atipamezole (0.037 mg/kg) was given intramuscularly 10 mins after extubation. The UNESP-Botucatu multidimensional composite scale was used to conduct pain assessments before premedication and at 20, 60, 120, 240 and 360 mins post-extubation or until rescue analgesia was given. To compare groups, the 60 min postoperative pain scores and the highest postoperative pain scores were analysed via a two-tailed Mann–Whitney test, and the incidences of rescue analgesia were analysed via a Fisher’s exact test; P <0.05. Results There was no significant difference between groups for the 60 min ( P = 0.68) pain scores. The highest postoperative pain score was higher for GIMT compared with GOT ( P = 0.04). Only two cats required rescue analgesia, both from GIMT. The incidence of rescue analgesia was not significantly different between groups ( P = 0.46). Conclusions and relevance In the present study, preoperative administration of oral tramadol at 6 mg/kg to cats provided adequate analgesia for 6 h following ovariohysterectomy surgery.

Download Full-text

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: a randomized controlled study

BMC Anesthesiology ◽

10.1186/s12871-019-0850-3 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Xue Li ◽

Zhen-Zhen Xu ◽

Xue-Ying Li ◽

Ting-Ting Jiang ◽

Zeng-Mao Lin ◽

...

Keyword(s):

Pain Intensity ◽

Abdominal Wall ◽

Analgesic Efficacy ◽

Opioid Consumption ◽

Transversus Abdominis ◽

Controlled Study ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Renal Surgery

Abstract Background Ultrasound-guided lateral transversus abdominis plane (TAP) block can provide definite analgesia to the anterior abdominal wall. However, whether this method is useful in renal surgery through the lateral abdominal wall pathway remains unknown. The study aimed to evaluate the analgesic efficacy of lateral TAP block for retroperitoneoscopic partial or radical nephrectomy. Method In this prospective, randomized, double-blind, placebo-controlled trial, eligible patients were randomized into two groups. After anaesthesia induction, ultrasound-guided lateral TAP block was performed with either 30 ml of 0.4% ropivacaine (Group T) or an equivalent volume of normal saline (Group C). The primary outcomes were opioid consumption during surgery and in the first 24 h after surgery. Secondary outcomes included postsurgical pain intensity immediately awakening from anaesthesia and at 0.5, 1, 2, 6, 12, and 24 h after surgery, as well as recovery variables including the incidence of postoperative nausea and vomiting (PONV), sleep quality, time to first ambulation, drainage and length of hospital stay. Results A total of 104 patients were enrolled and randomized (53 in Group T and 51 in Group C). Laparoscopic surgery was converted to open surgery in one patient of Group T; this patient was excluded from the outcome analysis. The opioid consumption during surgery (intravenous morphine equivalent dose: median 35.0 mg [interquartile range 18.0, 49.6] in Group C vs. 40.3 mg [20.9, 59.0] in Group T, P = 0.281) and in the first 24 h after surgery (10.8 mg [7.8, 21.7] in Group C vs. 13.2 mg [8.0, 26.6] in Group T, P = 0.311) did not differ significantly between groups. There were no significant differences between groups regarding the pain intensity at all time points after surgery and the recovery variables (all P > 0.05). Conclusions Our results showed that, in patients undergoing retroperitoneoscopic renal surgery, preoperative lateral TAP did not decrease intra- and postoperative opioid consumption, nor did it relieve pain intensity or promote postoperative recovery in the first 24 h after surgery. However, the trial might be underpowered. Trial registration This study was registered on November 4, 2017, in the Chinese Clinical Trail Registry with the identification number ChiCTR-INR-17013244.

Download Full-text

Comparative study of dexmedetomidine and clonidine as an adjunct to levobupivacaine in transversus abdominis plane block in patients undergoing total abdominal hysterectomy: a randomized control study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194368 ◽

2019 ◽

Vol 8 (10) ◽

pp. 3991

Author(s):

Bharti Gupta ◽

Amit Gupta ◽

R. K. Verma ◽

Payal Shah

Keyword(s):

Postoperative Analgesia ◽

Transversus Abdominis ◽

P Value ◽

Tap Block ◽

Ultrasound Guided ◽

Double Blind ◽

Randomized Control Study ◽

Pain Scores ◽

Randomized Control ◽

Control Study

Background: Ultrasound guided TAP block is safe, simple and effective method of providing postoperative analgesia in surgeries involving abdominal wall incision by blocking anterior branches of thoracolumbar nerves originating from T6-L1. Our aim to study the efficacy of dexmedetomidine and clonidine as an adjunct to levobupivacaine in ultrasound guided TAP block for postoperative analgesia in patients undergoing TAH.Methods: Prospective, double blind randomized control study. Ninety ASA I and II patients scheduled for TAH were randomly assigned in a double blinded study and divided into three groups. Group L received 18ml of 0.25% levobupivacaine+2ml of NS to make total volume of 20ml on each side. Group LC and Group LD received 18ml of 0.25% levobupivacaine + 1 mcg/kg of clonidine or dexmedetomidine diluted in NS to make total volume of 20ml on each side. USG guided TAP block was given when subarachnoid block level regressed to T10 level. Postoperatively patients were assessed for pain scores, HR, SBP, DBP, nausea vomiting, sedation and satisfaction scores at 0, 2, 4, 6 and 12 and 24 hours. Statistical analysis was performed using SPSS software 17. p value<0.05 was considered significant.Results: Pain scores were significantly lower in LD and LC groups as compared to L group and demand for first rescue analgesic was delayed in LD group (491.50±73.29min) and group LC (268.00±35.47min) as compared to group L (129.17±10.67min). The total number of demand doses in 24 hours were significantly less in group LD (1.00±0.00) followed by group LC (2.03±0.18) and group L (2.77±0.57) respectively. Incidence of hypotension, bradycardia and sedation was more in LD group as compared to LC and L groups.Conclusions: TAP block with dexmetomidine as an adjunct to levobupivacaine provides prolonged postoperative analgesia as compared to clonidine as an adjunct and plain levobupivacaine.

Download Full-text

A prospective study of efficacy of ultrasound guided transversus abdominis plane block for postcesarean analgesia

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20191949 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1951

Author(s):

Sravani Manam ◽

R. N. V. Swetha ◽

A. S. Kameswara Rao ◽

S. G. K. Murthy

Keyword(s):

Total Dose ◽

Postoperative Period ◽

Transversus Abdominis ◽

Control Group ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Rescue Analgesia ◽

Significant Difference ◽

Group B

Background: The ultrasound guided transversus abdominis plane (TAP) block which provides effective analgesia after lower abdominal surgeries including caesarean section. It is a simple and reliable technique. In this prospective, randomized double-blind study, we determined the efficacy of TAP block using 0.25% Bupivacaine and 0.9N Saline with respect to VAS for pain, postoperative Tramadol consumption and post-operative ondansetron usage.Methods: This study was conducted on 100 adult patients of ASA physical status I and II in the age group of 18 to 40 years undergoing elective lower segment cesarean section under spinal anaesthesia. Study group received TAP block with 0.25% Bupivacaine and control group received 10 ml of 0.9N saline on each side. Patients were analyzed for postoperative pain by pain score (at rest, on movement, on cough) using VAS was recorded at 0, ½, 1, 2, 4, 6, 12 and 24 hours postoperatively. Need for rescue analgesia was assessed by time to first dose of Tramadol requirement and total dose of Tramadol over 24 hours of postoperative period. Ondansetron (4 mg i.v.) was administered whenever nausea score was more than 2 or the patient vomited. All the data was noted using uniform performs.Results: Patients received TAP block with 0.25% Bupivacaine had better pain scores at first hour of postoperative period during rest, cough and movement which was statistically significant (p<0.0010) in comparison to group B. There was a statistically significant difference (p <0.001) in the requirement of total dose of Tramadol as a rescue analgesia in patients who received transversus abdominis block with 0.25% Bupivacaine (138.77 mg) in comparison with other group(240 mg).The mean time to first request for Tramadol was significantly longer in group A (5.8 hrs) in comparison to group B (1.93 hrs) with p value <0.001. Patients received TAP block with 0.9N saline needed more dose of Ondansetron, however, the difference was not statistically significant (p >0.001).Conclusions: TAP block using ultrasound provides substantial reduction in Tramadol consumption, time to first dose of rescue tramadol when compared with control group. This study reinforces the recommendation for TAP as a part of multimodal post-operative analgesic regimen.

Download Full-text