ANALGESIC EFFICACY OF ULTRA-SOUND GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK WITH TOTAL ABDOMINAL HYSTERECTOMY | ||||
| Zagazig University Medical Journal | ||||
| Article 11, Volume 21, Issue 6, November 2017, Page 1-9 PDF (843.83 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2017.4585 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Ismail Abd El Gawad; Ayman Emara; Said Abd El Hameed; Mohammed Elsayed | ||||
| Anesthesia Department Al Azhar University, Cairo Egypt | ||||
| Abstract | ||||
| Background: Pre-incisional bilateral Ultra-sound guided transverses abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents for postoperative analgesia. The aim of this study is, assess the effectiveness of Ultra-sound guided TAP block on requirement of intra-operative fentanyl and post-operative analgesia in patients undergoing total abdominal hysterectomy. Subjects and Methods: Eighty patients ASA physical status I and II, were randomly allocated into two groups (40 patients each), group TAP: received bilateral Ultra-sound guided TAP block with 20ml bupivacaine 0.25% in each side and group GA: received Ultra-sound guided TAP with same volume of normal saline. both groups given standardized GA. Intra-operative fentanyl requirements and postoperative pain using visual analogue score (VAS) at 30 min.1, 2, 3, 6, 12 and 24 h post-operatively were assessed and if VAS ≥3, patients received i.v. pethidine as a rescue analgesic and time to first request of analgesia was recorded. Results: Intra-operative fentanyl requirement reduced in TAP group compared to GA group; it was 100.4±21.6 and150.3±24.3 mcg respectively. Time to the first analgesic request was also reduced in TAP group compared to GA group; it was112.5±5.4 min.vs.23.4 ± 2.3 min respectively. VAS at most post-operative measurement points and pethidine requirement were reduced in TAP group compared to GA group; (41.7 and 92.3 mg respectively).There were no recorded complications attributed to the TAP block procedure. All TAP group patients were highly satisfied with their postoperative analgesic regimen. Conclusion: TAP block provides effective intra and postoperative analgesia, prolongs time to the first analgesic request and reduces total intra and postoperative analgesic consumption with minimal PONV after total abdominal hysterectomy. | ||||
| Keywords | ||||
| perioperative analgesia; ultrasound guided transversus abdominis plane block | ||||
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