Efficacy of Double Pop Blind TAP Block – Double-Blinded Randomized Controlled Study

Abstract

Background: The transversus abdominis plane block (TAP block) in the petit triangle is being used since 2001 for analgesia by blocking the T6 to T12 nerves, which is devoid of the sympathetic blockade and has opioid-sparing effect during and after abdominal operations. The appropriateness and efficacy of using double pop blind transversus abdominis plane block were studied in abdominal surgeries using bupivacaine with butorphanol as additive. Subjects and Methods: A total of 78 adult patients of ASA I and II were included, who were to undergo laparoscopic cholecystectomy under general anesthesia. The control group patients received tramadol, diclofenac, and paracetamol in the perioperative period. The study group patients received TAP block by double pop blind technique after induction of anesthesia but before surgical incision as preemptive analgesia. The p-value, the mean and the confidence interval were calculated by using Student t-test with the use of online software by graphpad.com. Results: Each of the two groups had 39 patients, and none met the exclusion criteria. Patients of the study (TAP) group remained pain-free for a longer time by 439 (416 – 463) minutes more than the control (IV, Intravenous) group. Rescue analgesia in the study group was required 640 minutes after the end of the surgery, but in the control group, rescue analgesia was required earlier at 200 minutes only after the surgery. Conclusion: Double pop blind technique for TAP block is appropriate and without complications if done with carefulness as to avoid penetration of the blunted green needle beyond the fascia between the internal oblique and the transversus abdominis muscle.