Анестезия и клинические исследования
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Evaluation of USG Guided Transversus Abdominis Plane Block for Post- Operative Analgesia in Total Abdominal Hysterectomy Surgeries

Natesh Prabhu, Alok Kumar Bharti, Ghanshyam Yadav, Vaibhav Pandey, Yashpal Singh, Anil Paswan, Bikram Kumar Gupta and Dinesh Kumar Singh

Introduction and aims: Transversus abdominis plane (TAP) block is a fascial plane block providing postoperative analgesia in patients undergoing surgery with infraumbilical incision. This single blind prospective randomised control study aimed to evaluate the effectiveness of the TAP block for postoperative pain, as part of a multimodal analgesic regimen in patients undergoing TAH.

Material and methods: Sixty adult female patients undergoing Total Abdominal Hysterectomy (TAH) under general anaesthesia were randomized to undergo TAP block with Ropivacaine along with intravenous paracetamol and diclofenac in group I (n=30) verses group II (n=30) with intravenous paracetamol and diclofenac alone. All patients were given inj. paracetomol 1 gm infusion and inj. diclofenac 75 mg intravenously along with induction of anaesthesia. Group I patients additionally received ultrasound guided TAP Block bilaterally with Ropivacaine (0.25%) (25 ml on either side). Each patient was accessed separately by blinded observer at regular interval up to 24 h for visual analogue scale (VAS), analgesic requirement, PONV and sedation using Ramsay sedation scale. If patients complained of pain or VAS>3, inj. Morphine 0.1 mg/kg was given. The observation in two groups was compared statistically using chi-square test and Paired t-test and analysed by SPSS version 18 software.

Result: Result showed that the mean visual analogue score (VAS) of group1 was statistically less than group 2 (P<0.001). Mean analgesic requirement in mg for first 24 h postoperatively was significantly less in group 1 (5.40 ± 3.701) than group 2 (9.40 ± 3.856)

Conclusion: TAP Block is easy to perform under ultrasound guidance without complication and it provides effective analgesia. TAP Block holds well as a part of multimodal analgesia regimen for patients undergoing Total Abdominal Hysterectomy.