Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption. Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section. Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively. Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points. Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

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A Comparison of effect of preemptive versus postoperative use of ultrasound-guided bilateral transversus abdominis plane (TAP) block on pain relief after laparoscopic cholecystectomy

Scientific Reports ◽

10.1038/s41598-021-04552-6 ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Poupak Rahimzadeh ◽

Seyed Hamid Reza Faiz ◽

Kaveh Latifi-Naibin ◽

Mahzad Alimian

Keyword(s):

Laparoscopic Cholecystectomy ◽

Pain Relief ◽

Pain Score ◽

Postoperative Analgesia ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Rescue Analgesia ◽

Significant Difference

AbstractNowadays, there are various methods to manage pain after laparoscopic cholecystectomy. The aim of this study was to compare the effectof preemptive versus postoperative use of ultrasound-guided transversus abdominis plane (USG-TAP) block on pain relief after laparoscopic cholecystectomy. In this single-blinded randomized clinical trial, the patients who were candidates for laparoscopic cholecystectomy were randomly divided into the two groups (n = 38 per group). In the preemptive group (PG) after the induction of anesthesia and in the postoperative group (POG) after the end of surgery and before the extubation, bilateral ultrasound-guided transversus abdominis plane (TAP) block was performed on patients using 20 cc of ropivacaine 0.25%. Both groups received patient controlled IV analgesia (PCIA) containing Acetaminophen (20 mg/ml) plus ketorolac (0.6 mg/ml) as a standard postoperative analgesia and meperidine 20 mg q 4 h PRN for rescue analgesia. Using the numerical rating scales (NSR), the patients’ pain intensity was assessed at time of arrival to the PACU and in 2th, 4th, 8th, 12th, 24th h. Primary outcome of interest is NSR at rest and coughing in the PACU and in 2th, 4th, 8th, 12th, 24th h. Secondary outcomes of interests were the time to first post-surgical rescue analgesic and level of patients’ pain control satisfaction in the first 24 h. The USG-TAP block significantly decreased pain score in the POG compared to the PG, and also the pain was relieved at rest especially in 8 and 12 h (p value ≤ 0.05) after the surgery. Pain score after coughing during recovery at 2, 8 and 12 h after the operation were significantly decreased. (p value ≤ 0.05) The patient satisfaction scores in the POG were significantly higher in all times. There was a statistically significant difference between the two groups in terms of rate of postoperative nausea and vomiting (PONV), indicating that patients in the POG had significantly lower incidences of the PONV compared tothe PG. The time to first analgesic request was significantly shorterin the POG, which was statistically significant (p value = 0.089). There was no statistically significant difference between the two groups in terms of consumption of analgesics. The postoperative TAP block could offer better postoperative analgesia than preepmtive TAP block.

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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.

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Comparative study of ropivacaine versus dexmedetomidine-ropivacaine combination in transversus abdominis plane block for postoperative pain control in plastic surgery patients undergoing abdominoplasty

International Surgery Journal ◽

10.18203/2349-2902.isj20195400 ◽

2019 ◽

Vol 6 (12) ◽

pp. 4393

Author(s):

Summaira Jan ◽

Tawheed Ahmad ◽

Saima Rashid

Keyword(s):

Test Group ◽

Transversus Abdominis ◽

Control Group ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Post Operative Pain ◽

Significant Difference ◽

Initial Onset

Background: Requirement of postoperative analgesic medication is decreased by the use of regional nerve blocks. Transversus abdominis plane (TAP) block is an effective way to provide postoperative analgesia in abdominal surgeries. TAP block using ropivacaine alone has not been consistently proven to be effective in alleviating pain after abdominal surgeries. The objective of the study was to compare the combination of dexmedetomidine and ropivacaine to ropivacaine alone in TAP block for abdominoplasty patients. Time to onset of post-operative pain and time interval for need of rescue analgesia were compared.Methods: Sixty ASA (American Society of Anesthesiology) grade I or II patients undergoing abdominoplasty were allocated to two groups with thirty patients in each group. In this randomized, controlled, double-blinded study, the test group received TAP block using 20 ml (100 mgs) 0.5 percent of ropivacaine mixed with 50 µg of dexmedetomidine while as Control group received TAP block with 20 ml (100 mgs) of 0.5 percent of ropivacaine alone. Patient demographics, time to initial reporting of post-operative pain, time to need of first rescue analgesia, quality of pain block and side effects were recorded.Results: Time to initial onset of pain and time to need of first rescue analgesia were significantly longer in the test group than control group. The two groups were similar in demographics and quality of pain block, with no significant difference in side effects.Conclusions: Addition of dexmedetomidine to ropivacaine for TAP block in abdominoplasty patients prolong the time to initial onset of pain and time to need for first rescue analgesia.

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Evaluation of the Postoperative Analgesic Effect of 2 Different Blocks after Pediatric Circumcision Surgery

Urologia Internationalis ◽

10.1159/000519475 ◽

2021 ◽

pp. 1-6

Author(s):

Mehmet Mutlu ◽

Seray Turkmen

Keyword(s):

Observational Study ◽

Pain Score ◽

Postoperative Analgesia ◽

Prospective Observational Study ◽

Transversus Abdominis ◽

Block Group ◽

Tap Block ◽

Analgesic Requirement ◽

Rescue Analgesia ◽

Significant Difference

Background: Circumcision is a painful day-case surgery. Regional anesthesia techniques are used effectively for anesthesia and postoperative analgesia after pediatric circumcision surgery. Objective: Our prospective observational study aimed to compare postoperative analgesic efficiency of a dorsal penile nerve (DPN) block with a transversus abdominis plane (TAP) block after male pediatric circumcision surgery and complications related to each block. Study Design: We enrolled 80 male children under the age of 10 years with American Society of Anesthesiologists I–II status scheduled for circumcision in this prospective observational study. A TAP or DPN block was performed after induction of general anesthesia before surgery with ultrasound (US) guidance. Postoperative pain was assessed with Faces Pain Scale-Revised and the Faces, Legs, Activity, Cry and Consolability scale. Results: There was no statistically significant difference between the groups regarding 30-min pain score levels (p > 0.05). But, the 1st hour, 2nd hour, 6th hour, 12th hour, and 24th-hour pain score levels in the TAP block group were statistically significantly higher than those of the DPN block group (p < 0.05). The 1st rescue analgesic requirement in the TAP block group was at the 6th hour postoperative. There was no need for rescue analgesia in the DPN block group during the postoperative 24-h follow-up. Discussion: A US-guided DPN block provided effective and long-lasting postoperative analgesia for circumcision surgery with statistically significantly lower pain score levels than a US-guided TAP block. Conclusion: This study found that a TAP block alone was insufficient to provide adequate postoperative analgesia for circumcision surgery compared to DPN block.

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Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

The Open Anesthesia Journal ◽

10.2174/2589645802115010022 ◽

2021 ◽

Vol 15 (1) ◽

pp. 22-29

Author(s):

Tamer N. Abdelrahman ◽

Rasha G. Abu-Sinna

Keyword(s):

Magnesium Sulphate ◽

Transversus Abdominis ◽

Anesthetic Technique ◽

Control Group ◽

Time Interval ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Rescue Analgesia ◽

Group D

Introduction: The TAP block is a regional anesthetic technique, which blocks neural afferents between T6 and L1, which provide anterior abdominal walls and therefore help to alleviate postoperative pain. Aim: The aim is to compare the efficacy of preoperative single low dose of intravenous MgSO4 versus intravenous dexamethasone as adjuvants to ultrasound guided TAP block for prolongation of postcesaren analgesia. Materials and Methods: A total 60 pregnant females were selected undergoing elective caesarean sections under general anesthesia with ultrasound-guided transversus abdominis plane (TAP) block done at the end of surgery. Patients were randomly and equally allocated into three groups of 20 patients each. The first group of patients were classified as magnesium sulphate group (M)who received 50 mg/Kg IV, the second group of patients were classified as dexamethasone group (D) who received 2 mg IV and the third group was classified as the placebo group (C) who received IV saline. Results: Comparison of the VAS at 6 and 12 hours postoperatively showed statistically significantly lower values in group (M) and group (D) compared to group (C) and also group (M) was significantly lower than group (D) as well. The time interval until first rescue analgesia (Nalbuphine) needed by the patients (VAS ≥ 50) was significantly longer in group (M) compared to group (D) and group (C) consecutively. Additionally, it was significantly longer in group (D) than in the control group(C). The total dose of rescue analgesia consumed during the first 24 hours postoperatively was significantly lower in groups (M) than in group (D) and both groups showed lesser doses compared to group (C) Conclusion: We concluded that both MgSO4 and dexamethasone could prolong the postoperative duration and analgesic efficiency provided by the TAP block in cesarean sections. This further reduced the demands for postoperative rescue analgesia, with MgSO4 found to be more efficient than IV dexamethasone. Clinical Trial Registration Number: NCT04223128

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Circumcision in children: postoperative analgesic efficiency of transversus abdominis plan block vs caudal epidural block: a prospective observational study

10.31083/jomh.2021.096 ◽

2021 ◽

pp. 1

Keyword(s):

Postoperative Pain ◽

Observational Study ◽

Postoperative Analgesia ◽

Prospective Observational Study ◽

Transversus Abdominis ◽

Tap Block ◽

Rescue Analgesia ◽

Pain Scores ◽

Significant Difference ◽

Caudal Epidural

Background and objective: Circumcision is one of the most common operations and can cause postoperative pain, fear, and anxiety for children. This study aims to compare the effects of transversus abdominis plane (TAP) block and caudal epidural (CE) anesthesia on postoperative analgesia after circumcision in providing postoperative pain control. Methods: Eighty boys aged 1 to 14 years who underwent elective circumcision surgery under general anesthesia either with USG-guided TAP block or with CE block for postoperative analgesia were enrolled consecutively to this prospective observational study equally in each group. Postoperative pain scores and need for rescue analgesia were recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in mean age and Aldrete scores (p > 0.05). Body mass index (BMI) of the caudal block group was statistically lower than the TAP group (p < 0.05). While there was no statistically significant difference between the groups in 30th-minute VAS values (p > 0.05), the CE block group's 1st, 2nd, 4th, 8th, 12th, 18th, and 24th hour VAS values were statistically lower than the TAP block group's (p < 0.05). Conclusion: USG-guided TAB block under general anesthesia was not associated with lower postoperative pain scores and delayed rescue analgesia need compared with CE block in patients who underwent elective circumcision surgery. CE block provided superior analgesia than the USG-guided TAP block after elective circumcision surgery in this study.

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Evaluation of efficacy of bupivacaine and bupivacaine plus clonidine in transversus abdominis plane (TAP) block for postoperative analgesia: a prospective, randomized, double blind, comparative study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174602 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4588 ◽

Cited By ~ 1

Author(s):

Tauqeer Anjum Mir ◽

Aabid Hussain Mir ◽

Tantry Tariq Gani ◽

Abida Yousuf ◽

Sheikh Irshad Ahmad

Keyword(s):

Postoperative Analgesia ◽

Transversus Abdominis ◽

P Value ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Group I ◽

Group Ii ◽

The Difference

Background: Pain is the commonest symptom encountered postoperatively and hence multimodal analgesia is tried to overcome it. In this study, we have compared bupivacaine and bupivacaine plus clonidine in transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing lower abdominal surgeries under spinal anaesthesia.Methods: Sixty ASA I and II patients in the age range of 18-60 years undergoing various lower abdominal surgeries were randomly divided into two groups, who were operated after giving spinal block using 2.5 ml of 0.5% hyperbaric bupivacine and 25ug of fentanyl. At the end of surgical procedure tranversus abdominis plane (TAP) block was given by giving 25 ml of injection bupivacaine 0.25% in group I and 25 ml of 0.25% of bupivacaine with 1 ug.kg-1 of clonidine in group II. Quality of analgesia was assessed by visual analogue scale (VAS), categorical pain scoring system and frequency of rescue analgesia given and duration was assessed with the time at which first rescue analgesia was given. Side effects of clonidine such as sedation, bradycardia and hypotension were also noted. The hemodynamic parameters like heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were noted for both the groups.Results: Demographic characteristics like age, weight, sex, ASA class and type of surgeries were comparable in both groups. SBP, DBP and HR were less in group II than in group I and was statistically significant (p-value<0.05). The overall mean VAS score in group I was 3.03 ± 1.57 and group II was 1.72 ± 1.02 with p-value of 0.0005 and hence better quality of analgesia in group II. Categorical pain scoring system also showed statistically better scores in group II than group I. The duration of analgesia which was calculated by mean time for first rescue analgesia in group I was 6.38 ± 2.56 hours and group II was 14.23 ± 4.63 hours with a p-value of <0.0001 and the difference was statistically significant. The mean number of doses of rescue analgesia in group I for the first 24 hours was 1.37 ± 0.89 and in group II was 0.60 ± 0.62 with a p-value of 0.0003 and the difference was statistically significant. Group II patients showed more sedation scores than group I patients (p-value <0.05). None of the patients had any episode of bradycardia or hypotension.Conclusions: Addition of clonidine 1 ug.kg-1 to 25 ml of 0.25% bupivacaine compared to 25 ml of 0.25% bupivacaine alone in tranverse abdominis plane (TAP) block improves quality of analgesia, increases duration of postoperative analgesia and decreases postoperative analgesic requirements with minimal side effects.

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Transversus abdominis plane block by landmark technique with ropivacaine versus bupivacaine for post-operative analgesia in patients undergoing lower segment caesarean section deliveries

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.118 ◽

2021 ◽

Vol 8 (4) ◽

pp. 551-555

Author(s):

Aishwarya M Chavan ◽

Geetha R Acharya ◽

Jyoti V Kale ◽

Nidhi R Dabral

Keyword(s):

Patient Satisfaction ◽

Caesarean Section ◽

Postoperative Period ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Lower Segment ◽

Rescue Analgesia ◽

Lower Segment Caesarean Section ◽

Group B

Transversus Abdominis Plane (TAP) Block is an efficacious abdominal field block which is widely used component of multimodal analgesia. Compare the efficacy of Inj. Ropivacaine 0.2% and Inj. Bupivacaine 0.2% when used in TAP block for post-operative analgesia in lower segment caesarean section deliveries(LSCS) done under spinal anaesthesia. Randomized double blinded prospective study conducted after institutional ethics committee in our institute. We have recruited sixty patients scheduled for an elective LSCS which were enrolled into two groups to receive TAP block with bupivacaine 0.2% 15ml Group B (n=30) versus ropivacaine 0.2% 15ml Group R (n=30) + dexamethasone 2mg bilaterally. TAP block was administered on completion of surgery. Primary objective was to compare time to rescue analgesia in postoperative period. Secondary Objectives wereto compare hemodynamic response during postoperative period, measure the intensity of pain using visual analogue scale (VAS), number of analgesic doses in first 24 hours, patient satisfaction with pain management and complications if any.SPSS software 16 version. Time for rescue analgesia was shorter in Group B (6.7 hour) than in Group R (9.47 hour) (p = 0.00). VAS was lower in Group R. Higher dose of analgesics was required in Group B (p=0.008). All this led to higher patient satisfaction score in Group R. This study concludes that 0.2% ropivacaine provided a longer duration of analgesia compared to 0.2% bupivacaine when used in TAP block for post-operative analgesia in LSCS deliveries.

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Comparative assessment of efficacy of various anesthesia options after cesarean section

Messenger of Anesthesiology and Resuscitation ◽

10.21292/2078-5658-2019-16-6-54-59 ◽

2020 ◽

Vol 16 (6) ◽

pp. 54-59

Author(s):

O. V. Ryazanova ◽

Yu. S. Аleksandrovich ◽

Yu. N. Gorokhova

Keyword(s):

Cesarean Section ◽

Postoperative Analgesia ◽

Stress Hormones ◽

Comparative Assessment ◽

Transversus Abdominis ◽

Visual Analogue Pain Scale ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Visual Analogue Pain ◽

Ropivacaine Hydrochloride

The article describes the comparative assessment of efficacy of transversus abdominis plane block as a component of multimodal analgesia during cesarean section.Subjects and methods. 165 primiparous women were enrolled into the study, their average age made 30.5 years. Operative delivery was performed under spinal anesthesia. All patients were divided into five groups. In the patients in Groups 1 and 3, postoperative analgesia was performed using transversus abdominis plane (TAP) block without ultrasound guidance, while in Groups 2 and 4, TAP block was guided by ultrasound. In Groups 1 and 2, ropivacaine hydrochloride was used at a concentration of 0.2%, in Groups 3 and 4 - 0.375%. In Group 5, paracetamol in combination with narcotic analgesics was used for analgesia. Pain intensity was assessed every hour using a visual analogue pain scale at rest and during movement during the 1st day after delivery. To assess the severity of the stress response and metabolic status of patients, concentrations of cortisol, prolactin and glucose in blood plasma was tested. The levels of cortisol and prolactin were tested in 4 stages: before surgery, 1 hour after surgery, 6 and 24 hours after delivery. Plasma glucose was tested in 3 stages: before surgery, 1 hour and 6 hours after surgery.Results. TAP block in combination with paracetamol provided adequate postoperative analgesia, reduced the consumption of analgesics, and also contributed to the earliest activation of new mothers after cesarean section. The use of 0.2% ropivacaine hydrochloride solution with TAP block was equally effective as the use of 0.375% solution of ropivacaine hydrochloride. Ultrasound guided TAP block significantly improved the quality of postoperative pain management. TAP block reduced the level of stress hormones in patients but in 24 hours, the levels of stress hormones in all groups of patients receiving and not receiving TAP block did not differ.

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BUPIVACAINE WITH MAGNESIUM SULPHATE VS BUPIVACAINE ALONE IN TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN TOTALABDOMINAL HYSTERECTOMY PATIENTS: A RANDOMISED CONTROL TRIAL.

10.36106/ijsr/7201358 ◽

2021 ◽

pp. 36-38

Author(s):

Suresh Babu R ◽

Sivakumar Pillai ◽

Syam Sankar

Keyword(s):

Magnesium Sulphate ◽

Blood Pressure Response ◽

Transversus Abdominis ◽

Randomised Control Trial ◽

Control Group ◽

Sensory Level ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Hyperbaric Bupivacaine ◽

Rescue Analgesia

Background: Postoperative (PO) pain relief following major surgeries had been a challenging task. Adequate pain control is essential for early mobilisation and wellbeing of surgical patients. Incidence of PO pain following abdominal surgeries is higher when transverse lower abdominal incisions are done as in Total Abdominal Hysterectomy (TAH). Performing Transversus Abdominis Plane (TAP) block reduces the PO pain. Various adjuvants like clonidine, epinephrine and magnesium sulphate have been added to local anaesthetics to prolong the duration of TAPblock. The aim of this study was to investigate the effects of adding MgSO4 as an adjuvant to bupivacaine in TAP block for PO analgesia in patients undergoing TAH under spinal anaesthesia. Methods: 100 patients belonging to ASA1 or 2 scheduled for TAH under Sub Arachnoid Block (SAB) were randomly assigned into two groups- BM and B. All patients were given SAB with 15 mg of 0.5% hyperbaric Bupivacaine and TAH was done. USG guided TAPblock was given once SAB sensory level regressed to T8 dermatome. Group BM received 16ml 0.25% Bupivacaine (40mg) with 150 mg magnesium sulphate injected on each side while Group B received 16 ml 0.25% Bupivacaine only. Patients were asked to rate their pain on a 10 cm VAS scale at time 0 (time of completion of TAPblock),2,4,6,12 and 24 hours. Rescue analgesia with Inj. morphine was provided whenever VAS score was > 3. Results: Patients in magnesium sulphate group had prolonged analgesia as compared to the control group. The heart rate and blood pressure response were signicantly lower in that group. Morphine requirement for PO analgesia was also signicantly reduced in group BM. No complications were seen in either group. Conclusion: Adding Magnesium sulphate to Bupivacaine in TAP block in TAH patients prolonged the duration of PO analgesia.

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