At high altitudes, no major advantage was found for epidural ropivacaine over bupivacaine in addition to fentanyl for labor analgesia and no harmful effects of the medications were found on mothers, fetuses, or newborns.
Background
The transversus abdominis plane (TAP) block is a known approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. Different adjuvants have been used to intensify the quality and the duration of local anesthetics.
Aim of the Work
The aim of this study is to detect the efficacy and safety of magnesium sulphate as an adjuvant to the analgesia offered by local anesthetic in ultrasound guided TAP block in patients undergoing surgical repair of moderate sized umilical hernia under general anathesia. As regard postoperative pain and opioid consumption using Visual Analogue scale VAS.
Patients and Methods
the study was carried out on 40 patients who was undergo surgical hernial repair, after ethical approval of Ain Shams University Hospital and informed consent from patients ,patients assigned in two group ,each group include 20 patients, Group 1: receive TAP block with Bupivacaine 0.25% 20 ml per side. Group 2: receive TAP block with Bupivacaine 0.25% 18 mL+2 ml magnesium sulphate.
Results
By the end of our study we found that VAS pain score was less in group II than in group I at 0,1,2 and 24 hours postoperatively and most significant at 4,6 and 12 hours the VAS score less in group II than group I (p value <0.05).And the mean time for first rescue analgesic dose was delayed in group II (872.87±265.25mins) compared to group I(466.54±118.29mins) (p value <0.001).
Conclusion
MgSO4 as an adjuvant to Bupivacaine in Ultra-sounded guided TAP block reduces postoperative pain scores, prolong the duration of analgesia and decreases demand for rescue analgesics.
Background
This prospective randomized study was performed on 80 patients, 21–60 years old, scheduled for open nephrectomy surgery. Patients were equally allocated to two groups: the transversus abdominis plane block (TAPB) group and the quadratus lumborum block (QLB) group. Both groups received 0.3 ml/kg of bupivacaine 0.25% on the side of the operation. Total postoperative pethidine consumption, time to rescue analgesia, postoperative visual analogue scale (VAS), and pethidine-related postoperative nausea and vomiting (PONV) were recorded.
Results
Total postoperative pethidine consumption was significantly lower in the QLB group: 73.75 ± 23.99 mg versus 115.63 ± 31.87 mg in the TAPB group. Time to 1st rescue analgesia was significantly prolonged in the QLB group: 477.075 ± 49.2 min versus 430.825 ± 48 min in the TAPB group. The VAS was significantly lower in the QLB group, on arrival to the Post-Anesthesia Care Unit (PACU), and at 1, 4, 8, and 12 postoperative hours. At 16 and 24 postoperative hours, both groups showed nonsignificant differences in the VAS scores. In the QLB group, 20% of patients had PONV versus 35% of patients in the TAPB group with no significant difference.
Conclusions
QLB efficiently reduced pain after open nephrectomy surgeries, in terms of quality and duration of pain control compared to TAPB.
Trial registration
FMASU MD 90a/2021/2022. The trial was registered on the 23rd of May 2021, with Pan Africa Clinical Trials Registry (PACTR202110858627849) on 27 October 2021
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