Ultrasound Guided Transverse Abdominis Plane Block with Ropivacaine and Levobupivacaine Postoperative Analgesia in Patients undergoing Total Abdominal Hysterectomies-A Prospective Randomised Double Blinded Control Study

2017 ◽  
Author(s):  
R. Shashikala ◽  
Ramesh Babu ◽  
Shakeeb Yusufi ◽  
Mohsin Ali
Keyword(s):  
Postoperative Analgesia ◽  
Ultrasound Guided ◽  
Transverse Abdominis ◽  
Double Blinded ◽  
Control Study

scholarly journals 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

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.

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.

scholarly journals Ultrasound-guided ilioinguinal-iliohypogastric block (ILIHB) or perifocal wound infiltration (PWI) in children: a prospective randomized comparison of analgesia quality, a pilot study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bjoern Grosse ◽  
Stefan Eberbach ◽  
Hans O. Pinnschmidt ◽  
Deirdre Vincent ◽  
Martin Schmidt-Niemann ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Pediatric Patients ◽  
Data Availability ◽  
Anesthesia Induction ◽  
Ultrasound Guided ◽  
Wound Infiltration ◽  
Number Of Children ◽  
Pain Frequency ◽  
Double Blinded

Abstract Background Ilioinguinal-iliohypogastric block (ILIHB) is a well-established procedure for postoperative analgesia after open inguinal surgery in children. This procedure is effective and safe, especially when ultrasound is used. Data availability for comparing ultrasound-guided blocks versus wound infiltration is still weak. The study was designed to determine the efficacy of ultrasound-guided ILIHB (US-ILIHB) on postoperative pain control in pediatric patients following a inguinal daycase surgery, compared with perifocal wound infiltration (PWI) by the surgeon. Methods This randomized, double-blinded trail was conducted in pediatric patients aged from 6 months to 4 years. The total number of children included in the study was 103. Patients were allocated at random in two groups by sealed envelopes. The ILIHB group recieved 0,2% ropivacain for US-ILIHB after anesthesia induction. The PWI group recieved 0,2% ropivacain for PWI performed by a surgeon before wound closure. Parameters recorded included the postoperative pain score, pain frequency, time to first analgesics and consumption of analgesics. Results: US-ILIHB significantly reduced the occurrence of pain within the first 24 h after surgery (7.7%, p = 0.01). Moreover, the pain-free interval until administration of the first dose of opioids was 21 min longer, on average (p = 0.003), following US-ILIHB compared to perifocal wound infiltration. 72% of children who received US-ILIHB did not require additional opioids, as compared to 56% of those who received PWI. Conclusion Thus our study demonstrates that US-ILIHB ensures better postoperative analgesia in children and should be prioritized over postoperative PWI. Trail registration UIHBOPWIIC, DRKS00020987. Registered 20 March 2020 – Retrospectivley registered.

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