scholarly journals Comparison of ropivacaine and bupivacaine in ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing elective lower abdominal surgeries - A randomized double-blind trial

2021 ◽  
Vol 8 (2) ◽  
pp. 191-198
Author(s):  
Nidhi Sharma ◽  
Arnab Banerjee ◽  
Jyothi Jain ◽  
Pradeep Kumar Goyal
Keyword(s):  
Rating Scale ◽  
Transversus Abdominis ◽  
Double Blind Study ◽  
Tap Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Patient Satisfaction Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Ultrasound-guided Transversus Abdominal Plane (TAP) block is an effective and safe regional anaesthesia technique. Our study is aimed to draw a comparison between the analgesic efficacy of Ropivacaine and Bupivacaine using ultrasound-guided TAP block. After approval from our Institutional Ethical Committee, 100 ASA I and II patients were recruited. Patients of either sex in age group of 18–65 years, undergoing elective lower abdominal surgeries were included in this prospective double-blind study. Patients were randomized into two groups, A and B. Group A (n=50) patients received ultrasound-guided TAP block with 20 ml 0.5% Ropivacaine and those in group B (n =50) received 20 ml 0.25% Bupivacaine at the end of surgery. The postoperative pain score (Numeric Rating Scale, NRS), patient satisfaction score, total requirement of analgesics in the first 24 hours, and the side effects were observed. Statistical tests were conducted using student's t-test, chi-square test, or fisher's exact test whichever was applicable. P < 0.05 was considered statistically significant. Statistically significant difference in the pain scores were observed between the two groups at different time intervals. The mean NRS score was higher for group B at 2, 4, 6 and 14 hour following the block. The duration of analgesia was longer and the total requirement of analgesic was lesser in group A as compared to group B.(p<0.001)Ultrasound-guided TAP block with 0.5% Ropivacaine provides effective analgesia for longer duration and decreases the total analgesic consumption as compared to 0.25% Bupivacaine in lower abdominal surgeries.

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

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

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.

scholarly journals EFFICACY OF TAP BLOCK AND PLACEBO FOR PAIN IN PATIENTS UNDERGOING CSECTION SURGERY

2021 ◽  
Vol 71 (1) ◽  
pp. 266-69
Author(s):  
Usman Khalid ◽  
Kaukab Majeed ◽  
Maihmoona Yasmeen ◽  
Khalid Mehmood ◽  
Muhammad Ali Muazzam ◽  
...  
Keyword(s):  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Military Hospital ◽  
P Value ◽  
Double Blind Study ◽  
Transversus Abdominis Plane ◽  
Double Blind ◽  
Cross Sectional ◽  
Group A ◽  
Group B

Objective: To compare efficacy of transversus abdominis plane block and placebo for pain in patients undergoing C-section surgery. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital Quetta, from Apr toOct 2018. Methodology: A sample size of 200 patients calculated by WHO calculator undergoing Elective C-section andof age 20-40 year were randomized in a double blind study to undergo transversus abdominis plane block orplacebo group in two equal groups. Group A received block as placebo and group B with Bupivacaine. Resultsrecorded and analysed there-after for conclusion. Results: The mean age of patients in group A was 29.98 ± 5.18 years and in group B was 29.68 ± 5.43 years (pvalue ≤0.01). Majority of the patients 141 (70.50%) were between 31 to 40 years of age. Out of 200 patients, 108 (54.0%) were ASA I and 92 (46.0%) were ASA II (p-value ≤0.01). Mean body mass index was 25.20 ± 2.28 kg/m2 (p-value ≤0.01). Meantime for the first analgesia in the patients undergoing elective C-section in group A (placebo group) was 4.96 ± 1.44 hours while in group B (transversus abdominis plane block group) was 11.24 ± 1.83 hours (p-value ≤0.01). Conclusion: This study concluded that meantime for the first analgesia was found longer in TransversusAbdominis plane block for post-operative pain management in patients undergoing elective C-section.

scholarly journals Efficacy of laparoscopic guided transversus abdominis plane block in post operative analgesia requirement in elective laparoscopic cholecystectomy

2021 ◽  
Vol 8 (3) ◽  
pp. 925
Author(s):  
Hanuman Ram Khoja ◽  
Dhanush Kumar Kunchagi ◽  
Praveen Kumar Joshi ◽  
Prabha Om
Keyword(s):  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Vas Score ◽  
Significant Difference ◽  
Analgesia Requirement ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Minimal invasive surgery has many advantages. In order to maintain and control  pain, one of the most effective technique is Transversus abdominis plane (TAP) block technique. Aim of the study was to demonstrate the efficacy of laparoscopic guided transversus abdominis plane block in post-operative analgesia requirement in elective laparoscopic cholecystectomy.Methods: It was a hospital based prospective interventional study. Sample size was calculated at 0.05 α error and 80% study power assuming mean difference of VAS score between TAP block +/A group  and TAP block- /B group is 1 and standard deviation of VAS score 1.3 among patients undergoing elective laparoscopic cholecystectomy.Results: A total of 60 patients were enrolled in this study. The mean age of group A was 48.56 years and for group B was 43.53 years. In group A 80% patients were females and for group B 83.3% patients were females. There was significant difference in VAS score at immediate post operation, at 1 hour, at 6 hours, at 18 hours and at 24 hours as p value was <0.0001 for all these groups. The mean VAS score was recorded less in group A at all the time duration compared to group B.Conclusions: With advantages like maximum safety, efficacy, potential for lower visceral injury risk and shorter operational time and other numerous advantages (decreased analgesic requirements, etc.)  laparoscopic-guided TAP block counts as an ideal abdominal field block in the patients.

PREVENTION OF DEEP VEIN THROMBOSIS (DVT) BY ENOXAPARINE (LOVENOXR) AFTER SURGERY FOR FRACTURE OF FEMORAL NECK. ONE DAILY INJECTION OF 40 MG VERSUS TWO DAILY INJECTIONS OF 20 MG

1987 ◽  
Author(s):  
J BARSOTTI ◽  
B DABO ◽  
J ANDREU ◽  
D ALISON ◽  
J LEROY ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Lower Limbs ◽  
Daily Injection ◽  
Bleeding Complications ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Orthopedic Operation ◽  
Group A ◽  
Group B

In a previous open study, a low-molecular-weight-heparinEnoxa-parine in a dose of 40 mg/24 hrs by subcutaneous (SC) injection, had been shown to be efficient and safe in preventing DVT after total hip replacement (THR), for a non traumatic hip disease. 103 patients (mean age : 82 years ± 10, mean weight : 52 kg ± 10) undergoing an orthopedic operation for fracture of femoral neck were included ina randomized, double blind study. These patients receivedSC Enoxaparine according to two different regimens : 54 patients received the treatment A (2 daily injections of 20 mg), 49 patients received the treatment B (1 daily injection of 40 mg).In both groups, administration of 40 mg of Enoxaparine was begun 12 hours before operation.Patients weretreated for 10-15 days, until bilateral ascending phlebography (BAP) had been completed.Lower limbs BAP were performed in 97 patients. The incidence of DVT is low and not significantly different betweenthe two regimens :a proximal DVT was detected in 6 patients of the group A and in 2 patients of the group B. This differenceis not significant(p = 0.28).3 patients of each group hada distal DVT. No clinical pulmonary embolism occurred.There was no serious bleeding complication, and the two groups are not significantly different on this point; 2 patients in each group had an important hematoma of the thigh.One hematoma, in a patient who received the treatment B, required a surgical treatment.Red cell transfusion requirementswere 2.6U+1.8 in the group A and 2.5 U ±1.4 in the group B (p = 0.84)There was no significant difference in the daily hemoglobinlevels between the two groups.This study shows that one daily SC injection of 40 mg of Enoxaparine is as efficient as two daily SC injections of20 mg of Enoxaparine in preventing DVT, in very elderly patients undergoing orthopedic operation for fracture of the femoral neck. The frequencies of bleeding complications in each group were not significantly different.Enoxaparine (LOVENOXR) - PHARMUKA S.F.

scholarly journals EARLY RECOVERY FOLLOWING ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK (TAP) IN ABDOMINAL CONTOURING SURGERIES

2020 ◽  
Vol 8 (10) ◽  
pp. 1227-1231
Author(s):  
Nawaf Naif Alotaibi ◽  
◽  
Aljohara Mohmoud Hamza ◽  
Sari Monzer Rabah ◽  
Tawheed Ahmad ◽  
...  
Keyword(s):  
Demographic Characteristics ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Early Recovery ◽  
Vas Score ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background:The transversus abdominis plane (TAP) block is a well-known regional nerve block that is used for the pain control after various inguinal andabdominal surgeries. The most effective and well known method of administering the TAP block is under ultrasound guidance.Till now only few studies have evaluated analgesic efficacy of TAP block in Abdominoplastysurgical procedure, in which post-operative pain is a major concern for both surgeon as well for the patient. Objectives:We conducted retrospective cohort study to assess efficacy of ultrasound-guided bilateral TAP block, in controlling post-operative pain in abdominoplasty patients. Methods:Sixty Patients who had undergone Lipoabdominoplasty procedurewere studied retrospectively. The patients who had received TAP block were assigned as groups A and those patients who had not received any TAP block were assigned as group B, with thirty Patients in each group.The patients in two groups were compared for their demographic characteristics, pain intensity on mobilization, time to first rescue analgesic dose (visual analog scale (VAS) score ≥ 5 or on demand), opioid consumptionand incidence of nausea-vomitingepisodes during first post-operative 24 hours. Results:The patients in two groups were similar in demographic characteristics. Patients in group A (TAP block group) had required significantly smaller mean dose of postoperative opioids (Group A: 5mg Group B: 75 mg P = <0.000) and hadsignificantly longer mean time of first request for analgesic medication (Group A: 8 hours 11 minutes Group B: 1 hours 20 minutes P = <0.000).Median VAS score on mobilization was significantly lower in Group A(group A: 1 Group B: 5).Only Three patients in group A as compared to 18 patients in group B had experienced nausea and vomiting in post-operative period. Conclusions:The ultrasound guided TAP block provide more effective analgesia after Lipoabdominoplasty, which allows more comfortable early post-operative mobilization, decreases opioid requirement as well as opioid related side-effects, Therefore ultrasound guided TAP block should be considered in most of lipoabdominoplasty patients for better patient experience and outcome.

scholarly journals Analgesic and Respiratory Effects of Two Doses of Morphine as an Adjunct to Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block in Upper Abdominal Surgery

2019 ◽  
Vol 5 (22;5) ◽  
pp. 509-517
Author(s):  
Hala S. Abdel-Ghaffar
Keyword(s):  
Abdominal Surgery ◽  
Single Injection ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Morphine Group ◽  
Significant Difference ◽  
Group B ◽  
Upper Abdominal

Background: Opioid receptors are present at the terminals of afferent peripheral nerves; therefore, administration of opioids peripherally might provide a significant analgesic effect. Objectives: We investigated the analgesic efficacy of 2 different doses of morphine in bilateral subcostal single-injection ultrasound-guided transversus abdominis plane (TAP) block in abdominal surgery. Study Design: Randomized, controlled, double-blind trial. Setting: University hospital. Methods: We enrolled 90 patients (aged 18-60 years) who were scheduled for elective upper abdominal surgeries and received TAP block for postoperative analgesia. Patients received 20 mL bupivacaine 0.5% (group B) only or combined with 10 mg morphine (group BM10) or 15 mg morphine (group BM15). Study drugs were diluted with saline solution 0.9% to 40 mL volume and bupivacaine concentration of 0.25% and injected 20 mL on each side. Primary outcome was the verbal rating pain scale (VRS) over the first 24 hours postoperatively. Secondary outcomes were time to first request for analgesics, total analgesic consumption, lung spirometry, and adverse effects. Results: Compared with group B, patients in BM10 and BM15 groups showed significantly lower postoperative VRS scores at rest and during cough. Patients in BM15 group had lower VRS scores at the 24th hour postoperatively at rest (P = 0.034) and during cough (P = 0.040), compared with group BM10, with no significant difference at other timepoints. The median time to first request for intravenous patient controlled analgesia (PCA) nalbuphine was 10 hours (range, 6-12 hours) in group B versus 15 hours (8-18 hours; P = 0.000) and 16 hours (10-23 hours; P = 0.000) in BM10 and BM15 groups, respectively. Total consumption of nalbuphine PCA in BM15 group was 12 mg (6-18 mg) compared with 26 mg (20-34 mg; P = 0.000) and 18 mg (12-24 mg; P = 0.000] in groups B and BM10, respectively, with a significant difference between BM10 and BM15 groups (P = 0.000) and without significant adverse effects. Limitations: A limitation was a small sample size. Conclusions: Addition of morphine to bupivacaine in single-injection subcostal TAP block controlled pain and reduced opioid requirements after abdominal surgery in a dose–dependent manner. Key words: Abdominal surgery, analgesia, transversus abdominis plane block, morphine

scholarly journals TAP Block in Postoperative Analgesia, A First Time Clinical Trial In Bangladesh

2016 ◽  
Vol 27 (1) ◽  
pp. 3-11
Author(s):  
Bidhan Paul ◽  
Debashis Banik ◽  
AKM Shamsul Alam
Keyword(s):  
Postoperative Analgesia ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Analgesic Regimen ◽  
Time Period ◽  
Group A ◽  
Group B

Background: In perioperative care, a reliable pain management is a vital appeal. Over recent years, Transversus Abdominis Plane (TAP) block is introduced as an important component of multimodal analgesia.Objective: To evaluate efficacy of TAP block in postoperative analgesia for Total Abdominal Hysterectomy (TAH) with subarachnoid block (SAB) in comparison of morphine consumption and VAS score.Methods: 60 patients were randomly allocated into 2 groups (TAP group-A & control group-B). Standard SAB was applied to all patients for elective TAH. Immediate after operation classical TAP block was performed through both Lumber Triangle Of Petit (LTOP) of group A patients. Both groups were placed in Post Anesthesia Care Unit (PACU), arranged a common standard postoperative analgesic regimen for all, observed periodically and documented it accordingly in pre-designed data sheet.Results: TAP block prolonged the mean time of 1st required I/V morphine (TAP vs control, mean±SD 271.23±40.34 vs 195.33±22.16 min., p=0.001HS). Morphine requirement was also reduced (17.4±5.4 vs 26.2±4.4 mg, p=0.001HS). Pain VAS scores at rest and movement were also reduced at all time period (p? 0.01 to 0.001). There was no complication attributed to the TAP block.Conclusion: TAP block provided considerably effective postoperative analgesia in first 24 hours after major abdominal surgery like TAH.Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 3-11

scholarly journals Effects of Dexmedetomidine on Intraoperative Hemodynamic Responses in Patients Undergoing Laparoscopic Cholecystectomy: A Randomised Double Blind Trial

2021 ◽  
Author(s):  
Dhanashree Dongare ◽  
Smita Gharde
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Base Line ◽  
Loading Dose ◽  
Double Blind Trial ◽  
Hemodynamic Responses ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
American Society ◽  
Group B

Background: Dexmedetomidine is selective alpha 2 agonist with sedative sympatholytic, analgesic properties and is used as an anaesthetic adjuvant. We have evaluated the effect of dexmedetomidine on various hemodynamic responses to incidences such as laryngoscopy, endotracheal intubation, exubation and pneumoperitoneum in patients who were undergoing surgeries like laparoscopic cholecystectomy. We have used loading dose of 0.5mcg/kg of inj. Dexmedetomidine given over 10 minutes followed by infusion of a dose of 0.3mcg/kg/hour for the control of hemodynamic response to laparoscopy. Methods: Patient of either sex aged between 18-50 yrs, belongs to ASA I and II (AMERICAN SOCIETY OF ANAESTHESIOLOGY) posted for laparoscopic cholecystectomy were included. Institutional ethical committee clearance was obtained prior to study. After enrolment and valid written consent was taken. 60 patients were enrolled written valid informed consent was taken. Patients were divided into two groups 30 each with computerized randomization. Base line parameters were noted. Observer and patient was blinded for the content of syringe. Group A received injection dexmedetomidine and group B received bolus and infusion of normal saline at same rate. Routine general anaesthesia was instituted. Parameters were noted after induction, after intubation, after co2 insufflation, after 20 min, after 40 min, after co2 deflation, after extubation, after 1 and 2 hrs post-extubation. Results: Group A showed significantly less rise in HR and MAP than Group B. Requirement of intraoperative propofol was more in Group B. There was no significant difference for time taken to awakening in both groups. Conclusion: We found Injection Dexmedetomidine in given doses gave good hemodynamic control with minimal undesired effects during laparoscopy.

scholarly journals Pull vs. wet: rendimiento diagnóstico y calidad de las muestras de las PAAF guiadas por USE en las masas sólidas del páncreas

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Cecilia Curvale ◽  
Ignacio Málaga ◽  
Paloma Rojas Saunero ◽  
Viviana Tassi ◽  
Enrique Martins ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Double Blind Study ◽  
Cell Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Fine Needle ◽  
Significant Difference

Differential diagnosis of pancreatic masses is challenging. The endoscopic ultrasound-guided fine-needle aspiration method with the highest diagnostic yield has not been established. It was realized a prospective, randomized, double-blind study of the endoscopic ultrasound-guided fine-needle aspiration in solid lesions of the pancreas to compare and evaluate diagnostic yield and aspirate quality between wet and pull technique. Forty-one patients were enrolled. The wet technique presented a sensitivity, a specificity, a positive and negative predictive value, and a diagnostic accuracy of 58.3%, 100%, 100%, 25% and 63.4%, respectively. In the capillary technique they were: 75%, 100%, 100%, 35.7% and 78.1%, respectively. Comparing the diagnostic yield between both techniques, there was no statistically significant difference (McNemar’s test p = 0.388). Regarding the cellularity of the specimen, both in cytology and the cell block samples, no significant difference was observed between the techniques (p = 0.84 and 0.61, respectively). With respect to contaminating blood in the specimen, there was no difference in cytology samples (p = 0.89) and no difference in cell block samples (p = 0.08). The suitability of cytology samples for diagnosis was similar in both techniques (wet = 57.5% and capillary = 56.7%, p = 0.94) and there was no difference in cell block samples (wet = 75% and capillary = 66.1%, p = 0.38). In this study we did not observe differences in diagnostic yield or sample quality. Since both techniques are effective, we suggest the simultaneous and alternate use of both methods.

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