TAP Block in Postoperative Analgesia, A First Time Clinical Trial In Bangladesh

Abstract

Background: In perioperative care, a reliable pain management is a vital appeal. Over recent years, Transversus Abdominis Plane (TAP) block is introduced as an important component of multimodal analgesia.Objective: To evaluate efficacy of TAP block in postoperative analgesia for Total Abdominal Hysterectomy (TAH) with subarachnoid block (SAB) in comparison of morphine consumption and VAS score.Methods: 60 patients were randomly allocated into 2 groups (TAP group-A & control group-B). Standard SAB was applied to all patients for elective TAH. Immediate after operation classical TAP block was performed through both Lumber Triangle Of Petit (LTOP) of group A patients. Both groups were placed in Post Anesthesia Care Unit (PACU), arranged a common standard postoperative analgesic regimen for all, observed periodically and documented it accordingly in pre-designed data sheet.Results: TAP block prolonged the mean time of 1st required I/V morphine (TAP vs control, mean±SD 271.23±40.34 vs 195.33±22.16 min., p=0.001HS). Morphine requirement was also reduced (17.4±5.4 vs 26.2±4.4 mg, p=0.001HS). Pain VAS scores at rest and movement were also reduced at all time period (p? 0.01 to 0.001). There was no complication attributed to the TAP block.Conclusion: TAP block provided considerably effective postoperative analgesia in first 24 hours after major abdominal surgery like TAH.Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 3-11

Evaluation of Effectiveness of the Transversus Abdominis Plane Block to Provide Effective Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

“…According to Amr Y M 13 found that postoperative pain scores at rest in 2, 4, 8, 12, 24, 48 h were statistically significantly higher in the postsurgical TAP block group than those in the preincisional TAP block group (P<0.05) but Both groups demonstrated significantly lower pain scores than the control group at all time points assessed. Similar findings were reported by Nomaghave M et al 14 and Manjaree M et al 15. Present study is in accordance with the study done by Bidhan P (2014) 16 . In their study they found that pain VAS scores at rest were significantly lower (i.e.…”

“…Present study is in accordance with the study done by Carney J et al 11 , they found that, the median (interquartile range) time to first request for morphine was significantly longer in a patient who receive TAP Block (45 mint in tap block group Vs 12.5 mint in control group) and patients undergoing TAP block had reduced 48 hr morphine requirement ( 26.8±19.8 mg in tap block group vrs 55.3 ±17.6 mg in control group). Similar findings were reported by the authors such as Priya S et al 19 and Bidhan et al P 16 found that first I/V morphine requirement mean time ± SD was 271.23±40.34 (range 175-355) minutes in group A (TAP Block) and 195.33±22.16 (range 165-270) minutes in group B (Control Group). It was of highly significance of difference (p=0.001).…”