Authors : Heena Sanghavi, Vaishali Shelgaonkar
DOI : 10.18231/j.ijca.2023.048
Volume : 10
Issue : 3
Year : 2023
Page No : 223-228
Background: Transversus abdominis plane (TAP) block has emerged as a safe, reliable, and efficient technique to provide post-operative analgesia for a range of abdominal procedures and has been shown to minimize the usage of opioids in the perioperative period. This paper compares the overall efficacy and safety of TAP block for postoperative analgesia in abdominal surgeries, by two techniques (blind v/s USG).
Materials and Methods: Eighty patients, ASA grade I-II, 18-60 years age group, posted for abdominal surgery like appendicectomy, appendicular perforation, umbilical, paraumbilical, incisional and ventral hernia repair, hysterectomy and exploratory laparotomy under GA. They were divided into two groups to undergo blind or USG-guided TAP block. At the end of the procedure, before the reversal, both groups received a TAP block with Inj. Bupivacaine 0.25% 20cc on each side in supine position. Patients were followed up for 24 hours, and pain scores were measured using a visual analogue scale. Inj. Diclofenac was given as rescue analgesic and Inj. Tramadol was used for breakthrough pain. Total analgesic requirement for 24 hours and complications if any, were noted.
Results: VAS score was found to be significantly lower in USG- guided group at various time intervals till 12 hours (2.05 ± 0.75 vs 2.98 ± 1.03) in the USG-guided group as compared to the blind group (p<0>
Conclusion: USG-guided group had significantly less pain scores postoperatively and a reduced number of analgesic requirements. This resulted in fewer opioid-mediated side effects. TAP block can serve as a part of multimodal analgesia with enhanced recovery after abdominal surgery. The USG-guided approach helped in achieving near perfect block which is evident by pain scores and reduced analgesics required.
Keywords: Transversus abdominis plane block, Ultrasound- guided, Post- operative pain, Visual analogue scale.