scholarly journals A comparative study of postoperative analgesic efficacy between TAP block with wound infiltration in open gynaecological surgeries

2018 ◽  
Vol 6 (3) ◽  
pp. 889 ◽  
Author(s):  
Selvaraju G. ◽  
Nedumaran V. ◽  
G. Shanmugavelu
Keyword(s):  
Postoperative Analgesia ◽  
Local Anaesthetic ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Tap Block ◽  
Surgical Wound ◽  
Wound Infiltration ◽  
Abdominal Incision ◽  
The Government ◽  
Regional Anaesthetic Technique

Background: Gynaecological surgeries are performed by abdominal incision is common and post-operative pain and discomfort is always anticipated. TAP block is a regional anaesthetic technique which blocks the abdominal neural afferents by administrating local anaesthetic drugs into the neuro-fascial plane. The other method for postoperative analgesia is surgical wound infiltration with local anaesthetic drugs. The aim of this study was to evaluate the post-operative analgesic efficacy of TAP block versus wound infiltration in gynaecological surgeries.Methods: The study was a prospective randomized study conducted on patients undergoing open gynaecological surgeries, conducted at the Government medical college and ESI hospital, Coimbatore. The study was initiated after obtaining an ethical clearance from the institution. Group A: patients who underwent bilateral TAP block with 0.3 ml/kg 0.25% Bupivacaine on each side. Group B: patients who received wound infiltration of 0.25% Bupivacaine 0.6ml/kg.Results: TAP block provided superior analgesic effect than the surgical site infiltration group, without significant changes in the hemodynamic parameters. The duration of analgesia was longer and the need of Tramadol in the postoperative period was found to be lesser in the TAP block group as compared to wound infiltration group.Conclusions: The TAP block is an effective and safe technique for postoperative analgesia for gynaecological surgeries than compared to the surgical wound infiltration. The requirement of Tramadol as a postoperative analgesia was less with TAP block compared to surgical wound infiltration.

scholarly journals Comparison of Analgesic Efficacy of Transversus Abdominis Plane Block Versus Infiltration of Local Anaesthetic into Surgical Wound In Emergency Laparotomies: A Randomized Control Trial

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Anum Anwar ◽  
Hina Nabi Ahmed ◽  
Lala Rukh Bangash ◽  
Farah Arshad ◽  
Sahira Nawaz ◽  
...  
Keyword(s):  
Pain Score ◽  
Local Anaesthetic ◽  
Randomized Control Trial ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Emergency Laparotomy ◽  
Tap Block ◽  
Surgical Wound ◽  
Post Operative Pain ◽  
Randomized Control

Objective: To compare mean pain score of bilateral TAP block versus infiltration of local anaesthetic into surgical wound on for emergency laparotomies. Method: Randomized control trial. Emergency Operation Theatre in Department of Anaesthesiology at Mayo Hospital, Lahore from 1st April 2016 to 31st October 2016. Laparotomy 150 patients were arbitrarily allocated two groups Group T (receiving bilateral TAP block) and Group L (local infiltration) by random number table method after informed consent. TAP block was administered bilaterally by using 20ml of 0.25% bupivacaine in group T using a 21-gauge needle with the help of “Double Pop Technique” at midaxillary point at height of umbilicus. While in group L surgical incision site was injected with 20ml of 0.25% bupivacaine immediately after closure of skin. Pain was evaluated by Visual analogue scale (VAS) at 6-hour interval postoperatively. Results were statistically analysed using SPSS version 20.0 and t-test was applied to compare mean pain score of two groups. Results: Mean pain score in patients receiving bilateral TAP block 3.000±0.717 were significantly reduced (p value 0.003) versus mean scores in patients receiving infiltration of local anaesthetic into surgical wound in emergency laparotomies 6.08±1.171. Conclusion: Bilateral TAP block reduced post-operative pain significantly in patients undergone emergency laparotomy. Key Words: Emergency laparotomy, TAP block, local anaesthetic, bupivacaine, post-operative pain, analgesia. How to Cite: Anwar A, Nabi H.A, Bangash L.R, Arshad F, Nawaz S. Comparison of analgesic efficacy of transversus abdominis plane block versus infiltration of local anaesthetic into surgical wound in emergency laparotomies: a randomized control trial. Esculapio.2020;16(04):8-13.

scholarly journals Effects of Surgical Wound Infiltration with Bupivacaine on Postoperative Analgesia in Cats Undergoing Bilateral Mastectomy

2014 ◽  
Vol 76 (12) ◽  
pp. 1595-1601 ◽  
Author(s):  
Özge Turna YILMAZ ◽  
T. Seval Fatma TOYDEMIR ◽  
İsmail KIRŞAN ◽  
Banu DOKUZEYLUL ◽  
Zeynep GUNAY ◽  
...  
Keyword(s):  
Postoperative Analgesia ◽  
Bilateral Mastectomy ◽  
Surgical Wound ◽  
Wound Infiltration

Adjuncts to local anesthetic wound infiltration for postoperative analgesia: a systematic review

2020 ◽  
Vol 45 (8) ◽  
pp. 645-655
Author(s):  
Johnny Wei Bai ◽  
Dong An ◽  
Anahi Perlas ◽  
Vincent Chan
Keyword(s):  
Systematic Review ◽  
Postoperative Analgesia ◽  
Full Text ◽  
Subcutaneous Tissue ◽  
Analgesic Efficacy ◽  
Wound Infiltration ◽  
Surgical Wounds ◽  
Full Text Review ◽  
Protocol Registration ◽  
Abstract Screening

Local anesthetics (LAs) are commonly infiltrated into surgical wounds for postsurgical analgesia. While many adjuncts to LA agents have been studied, it is unclear which adjuncts are most effective for co-infiltration to improve and prolong analgesia. We performed a systematic review on adjuncts (excluding epinephrine) to local infiltrative anesthesia to determine their analgesic efficacy and opioid-sparing properties. Multiple databases were searched up to December 2019 for randomized controlled trials (RCTs) and two reviewers independently performed title/abstract screening and full-text review. Inclusion criteria were (1) adult surgical patients and (2) adjunct and LA agents infiltration into the surgical wound or subcutaneous tissue for postoperative analgesia. To focus on wound infiltration, studies on intra-articular, peri-tonsillar, or fascial plane infiltration were excluded. The primary outcome was reduction in postoperative opioid requirement. Secondary outcomes were time-to-first analgesic use, postoperative pain score, and any reported adverse effects. We screened 6670 citations, reviewed 126 full-text articles, and included 89 RCTs. Adjuncts included opioids, non-steroidal anti-inflammatory drugs, steroids, alpha-2 agonists, ketamine, magnesium, neosaxitoxin, and methylene blue. Alpha-2 agonists have the most evidence to support their use as adjuncts to LA infiltration. Fentanyl, ketorolac, dexamethasone, magnesium and several other agents show potential as adjuncts but require more evidence. Most studies support the safety of these agents. Our findings suggest benefits of several adjuncts to local infiltrative anesthesia for postoperative analgesia. Further well-powered RCTs are needed to compare various infiltration regimens and agents.Protocol registrationPROSPERO (CRD42018103851) (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=103851)

A Comparison of Naproxen, Indomethacin and Acetylsalicylic Acid in Pain after Varicose Vein Surgery

1978 ◽  
Vol 6 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Ulla Aromaa ◽  
Kari Asp
Keyword(s):  
Side Effects ◽  
Acetylsalicylic Acid ◽  
Postoperative Analgesia ◽  
Varicose Vein ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Varicose Vein Surgery ◽  
Double Blind ◽  
Post Operative Pain ◽  
Minor Surgery

Oral naproxen in doses of 500 mg and 750 mg daily was compared with oral indomethacin, 75 mg daily, in a double-blind, completely randomized study of patients with post-operative pain after out-patient varicose vein surgery. Altogether, 120 patients were studied. In the study 750 mg naproxen proved to be equal in respect of analgesic efficacy to 75 mg indomethacin, and it was clearly superior to 1500 mg acetylsalicylic acid. Naproxen, 500 to 750 mg daily, afforded adequate postoperative analgesia in 98% of patients. The side-effects were mild. On the basis of the study, naproxen can be recommended as a pain-relieving drug after minor surgery, particularly when an antiphlogistic effect is also desirable.

scholarly journals Comparison of analgesic efficacy between TAP block and local site infiltration post operatively in caesarean section

2018 ◽  
Vol 6 (4) ◽  
pp. 1407 ◽  
Author(s):  
Nabanita Das ◽  
Usha Shukla ◽  
Dheer Singh ◽  
Urvashi Yadav
Keyword(s):  
Caesarean Section ◽  
Postoperative Analgesia ◽  
Analgesic Efficacy ◽  
Tap Block ◽  
Local Site ◽  
Pain Scores ◽  
Group I ◽  
Significant Difference ◽  
Patient Pain ◽  
Study Population

Background: Patients undergoing caesarean section need to be alert, comfortable and mobile in order to take care of their babies, for which they must be pain free in post operative period. The aim of present study is to compare the analgesic efficacy of TAP block with local anaesthetic infiltration specifically in LSCS patients in reducing patient pain postoperatively, as well as to decrease the analgesic requirements.Methods: The study population consisted of 60 patients posted for elective and emergency caesarean section. They were blindly divided into two groups of 30 patients each. Group T received 40ml 0.25% Ropivacaine in Transverses abdominis plane (TAP) block for postoperative analgesia and group I received 40ml 0.25% ropivacaine as infiltration at incision site for postoperative analgesia. Patients were observed for numeric pain score NPS, analgesic requirements, total analgesic consumption and adverse effects if any.Results: There was highly significant difference in numeric pain scores at 2nd, 6th, 12th and 24th hours (p<0.0001). Both the time for first rescue analgesic and total amount of analgesic consumed are statistically significant (p<0.0001).Conclusions: TAP block is an effective postoperative analgesic procedure for post caesarean section patients.

scholarly journals The Analgesic Efficacy of Transverse Abdominis Plane Block versus Epidural Block after Caesarean Delivery: Which One Is Effective? TAP Block? Epidural Block?

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ebru Canakci ◽  
Ahmet Gultekin ◽  
Zubeyir Cebeci ◽  
Bulent Hanedan ◽  
Anil Kilinc
Keyword(s):  
Single Dose ◽  
Epidural Analgesia ◽  
Postoperative Analgesia ◽  
Epidural Anaesthesia ◽  
Analgesic Efficacy ◽  
Epidural Block ◽  
Tap Block ◽  
Hyperbaric Bupivacaine ◽  
Golden Standard ◽  
Vas Scores

Introduction and Objective. TAP block has gained popularity to provide postoperative analgesia after abdominal surgery but its advantage over epidural analgesia is disputed. For lower abdominal surgeries, epidural analgesia has been the gold standard and time-tested technique for providing postoperative analgesia, but contraindications for the same would warrant need for other equally good analgesic techniques. The objective of this study is to compare the analgesic efficacy of both the techniques. Materials and Methods. Eighty patients in the ASA I-II risk group, undergone an elective C-section, were randomly assigned to the study. In the TAP group, before the C-section, a single-dose spinal anaesthesia was performed by administering 3 ml of 0.5% hyperbaric bupivacaine to the patients when they were in the sitting position. After the C-section, an ultrasound-guided bilateral TAP block was performed in these patients in the recovery room for postoperative analgesia. In the single-dose EPI group, the patients received 16 cc of isobaric bupivacaine, 3 mg of morphine, and 50 mcg of fentanyl, making a total volume of 20 cc and being administered to the epidural space. Results. A higher level of patient satisfaction was observed in the EPI group (p=0.003). The amount (mg) of total analgesics received by the patients in the first 24 hours of the postoperative period was statistically significantly higher (p=0.021) in the TAP group compared to the EPI group. The visual analogue scale (VAS) scores of the EPI group were significantly lower compared to that of the TAP group (p<0.001). Conclusion. The epidural anaesthesia is still the golden standard to achieve a postcaesarean analgesia. Epidural anaesthesia is a considerably effective method in controlling the postoperative pain. We are of the opinion that epidural anaesthesia should be preferred in the first place to achieve a successful postcaesarean analgesia as it provides more effective pain control.

scholarly journals COMPARISON OF EFFICACY OF LEVOBUPIVACAINE IN TRANSVERSE ABDOMINIS PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING CAESAREAN SECTION: A DOUBLE BLINDED, RANDOMIZED STUDY

2020 ◽  
pp. 1-3
Author(s):  
Praveen S ◽  
Shashank M
Keyword(s):  
Caesarean Section ◽  
Postoperative Analgesia ◽  
Randomized Study ◽  
Local Anaesthetics ◽  
Tap Block ◽  
Rescue Analgesia ◽  
Transverse Abdominis ◽  
Group A ◽  
Group B ◽  
Double Blinded

Background: Dexamethasone has a long and efficient glucocorticoid structure and presents anti-inflammatory properties. When used as an adjuvant to local anaesthetics, it prolongs the duration of analgesia. The aim of this study was to determine the effect of dexamethasone as an adjuvant to levobupivacaine in TAP block given to patients who underwent caesarean section. Materials & Methods: 70 patients posted for caesarean section under spinal anaesthesia were included in the study and divided into two groups. Group A received bilateral 30 ml 0.25% levobupivacaine and 2 ml dexamethasone(8mg). Group B received bilateral 30 ml 0.25% levobupivacaine and 2 ml 0.9% NaCl in a TAP block performed with ultrasonography. The time needed for the first rescue analgesia in the postoperative period was recorded. 24hr tramadol consumption & VAS was recorded. Results: Time for first analgesic administration (tramadol) was prolonged significantly in Group A (mean ± SD- 12.24 ± 1.22hrs) as compared to Group B (mean ± SD ‑ 8.37± 1.07 hrs), P < 0.0001. Tramadol requirement for 24hrs in Group A was 115.71± 16.89 mg and for Group B was 198.57± 22.64 mg, which was statistically significant (P < 0.0001). VAS was noted at 2, 4, 6, 8, 12, 18 and 24 h. VAS was greatly reduced in group A for the first 8–10 h post‑operatively as compared to patients in group B. CONCLUSIONS: Dexamethasone when used as an adjuvant to levobupivacaine in TAP block, enhances the duration of block & decreases opioid consumption in the post- caesarean section patients.

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