Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy: a randomized, double-blind, placebo-controlled trial

Background: Transversus abdominis plane (TAP) blocks provide postoperative pain relief after various abdominal surgeries. Recently, erector spinae plane (ESP) block has obtained vast attention due to its simplicity and usage in truncal procedures. Objectives: This study aims to compare the ultrasound-guided bilateral ESP block versus bilateral TAP block on postoperative analgesia after open total abdominal hysterectomy. Study Design: A prospective, double-blinded, randomized, controlled, clinical trial. Setting: Zagazig University Hospitals. Methods: After ending of surgical procedure and before reversing of the muscle relaxant, 48 women were randomly allocated into 2 equal groups: erector spinae (ES) group received bilateral ultrasound-guided ESP block with 20 mL of bupivacaine 0.375% plus 5 ug/mL adrenaline (1:200000) in each side at the level of T9, and transversus abdominis (TA) group received bilateral ultrasound-guided TAP block with the same volume of bupivacaine plus adrenaline. Results: Visual Analog Scale scores at 30 minutes, 2, 4, 6, 8, 12, 16, 20, and 24 hours were statistically significantly lower in the ES group compared with the TA group. The time for requirement of first morphine was highly statistically significantly prolonged in the ES group (14.81 ± 3.52 hours) compared with the TA group (10.58 ± 2.35 hours). The total amount of morphine consumption in 24 hours postoperatively was statistically significantly decreased in the ES group; P = 0.01. Incidence of postoperative nausea and vomiting was higher but statistically insignificant in the TA group than the ES group. There were statistically significant numbers of unsatisfied patients (4) in the TA group compared with the ES group (no patient). Limitations: Sensorial evaluation of patients was not performed because both blocks had been done under general anesthesia but did not affect outcome. Therefore we recommend further studies comparing between both blocks. Conclusions: Bilateral ultrasound-guided ESP block provides more potent and longer postoperative analgesia with less morphine consumption than TAP block after open total abdominal hysterectomy. Key words: Abdominal hysterectomy, transversus abdominis plane block, erector spinae plane block, postoperative analgesia

Download Full-text

Ultrasound-guided transversus abdominis plane block does not improve analgesia after elective caesarean section when intrathecal diamorphine is used-A randomised double-blind controlled trial

Journal of Obstetric Anaesthesia and Critical Care ◽

10.4103/2249-4472.104735 ◽

2012 ◽

Vol 2 (2) ◽

pp. 98 ◽

Cited By ~ 1

Author(s):

Sireesha Aluri ◽

Ben Edwards ◽

Elizabeth Puddy ◽

Fleur Roberts ◽

Ian Wrench

Keyword(s):

Caesarean Section ◽

Controlled Trial ◽

Elective Caesarean Section ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Double Blind

Download Full-text

Effect of ultrasound-guided transversus abdominis plane block with rectus sheath block on patients undergoing laparoscopy-assisted radical resection of rectal cancer: a randomized, double-blind, placebo-controlled trial

10.21203/rs.3.rs-72105/v1 ◽

2020 ◽

Author(s):

Min Liang ◽

Xia Xv ◽

Chunguang Ren ◽

Yongxing Yao ◽

Xiujuan Gao

Keyword(s):

Controlled Trial ◽

Rectus Sheath ◽

Radical Resection ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Control Group ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Double Blind ◽

Rectus Sheath Block

Abstract BackgroundMany patients complain of pain following laparoscopic surgery. Clinicians have used ultrasound-guided posterior transversus abdominis plane block (TAPB) and rectus sheath block (RSB) for multimodal analgesia after surgery. We investigated the analgesic effects of US-guided posterior TAPB with RSB on postoperative pain following laparoscopy-assisted radical resection of early-stage rectal cancer.MethodsSeventy-eight adults scheduled for laparoscopy-assisted radical resection of rectal cancer were enrolled in this double-blind placebo-controlled trial. Patients were randomized into 3 groups: the TR Group underwent US-guided bilateral posterior TAPB (40 mL 0.33% ropivacaine) with RSB (20 mL 0.33% ropivacaine); the T Group underwent US-guided bilateral posterior TAPB alone; and the Control Group received saline alone. All patients also had access to patient-controlled intravenous analgesia (PCIA) with sufentanil. The primary outcome was postoperative sufentanil consumption at 0–24, 24–48, and 48–72 h. The secondary outcomes were postoperative pain intensity and functional activity score at rest and while coughing for the same three time periods, intraoperative medication dosage, use of rescue analgesia, recovery parameters, and adverse effects.ResultsThe three groups had no significant differences in baseline demographic and perioperative data, use of intraoperative medications, recovery parameters, and adverse effects. The TR group had significantly lower postoperative use of PCIA and rescue analgesic than in the other two groups (P < 0.05), but the Control Group and T Group had no significant differences in these outcomes.ConclusionsPostoperative US-guided posterior TAPB with RSB reduced postoperative opioid use in patients following laparoscopy-assisted radical resection of rectal cancer.Trial registrationThe trial was registered with chictr.org (ChiCTR2000029326) on January 25, 2020.

Download Full-text