Authors : Shivika Nath, Sahil Gupta, Dipankar Dhar, Suneva Sadhu, Dushyant Nadar
DOI : 10.18231/j.ijca.2020.016
Volume : 7
Issue : 1
Year : 2020
Page No : 88-93
Introduction: Postoperative pain is a common complaint following laparoscopic nephrectomies and in
these patients transverse abdominis (TAP) block is a useful an effective analgesic modality in controlling
pain compared to other techniques. This prospective randomized comparative study is to compare the
analgesic efficacy of unilateral TAP block versus bilateral TAP block for better analgesia postoperatively.
Materials and Methods: A total of 60 ASA I-II patients undergoing lapararoscopic nephrectomies (18-
60 years) were included and divided into two groups A(n=30) and B(n=30). Group A: Lateral ultrasound
guided(USG) unilateral TAP block with 20ml of 0.25% isobaric bupivacaine. Group B: Lateral USG guided
bilateral TAP block with 20ml of 0.25% isobaric bupivacaine at the end of surgery before extubation.
Statistical Design: the statistical testing conducted using statistical package for the social science system.
For all statistical tests, a p value less than 0.05 was taken to indicate a significant difference.
Results: We found that total mean analgesic duration of the block was significantly longer in bilateral
(B) group (14.3h2.48h rs) as compared to group A(6.22.14hrs) with p value of 0.000000017564. VAS
scores were significantly higher in the group A with p value of 0.00000000124575. The mean number of
doses of additional rescue analgesia (i.e fentanyl) in Group A was 3.12 0.72 as compared to 1.04 0.73
in Group B (given at 18 hrs.), the p value comes out to be 0.0000000125 which is statistically significant.
Conclusion: Bilateral USG guided TAP block is of more benefit than unilateral TAP block in reducing
postoperative pain and also reduced overall use of opioids in laparoscopic nephrectomies.
Keywords: Nephrectomies, Ultrasound, TAP block, Bilateral.