A comparative study between transversus abdominis block with ropivacaine (0.2%) and fentanyl versus plain ropivacaine (0.2%) for postoperative analgesia in lower abdominal surgeries under general anesthesia

Abstract

Background: Lower abdominal surgeries are associated with significant visceral, somatic, and neuropathic pain in postoperative period. Transversus abdominis plane block (TAP) is a technique used in the management of surgical abdominal pain by injecting local anesthetic in the plane between internal oblique and transversus abdominis muscles. We compared utility of TAP block using ropivacaine alone and also in combination with fentanyl for patients undergoing abdominal surgeries. Aim: To compare ropivacaine (0.2%) versus ropivacaine (0.2%) plus fentanyl (1 mcg/kg) used in transversus abdominal plane for the management of postoperative abdominal pain. Objective: To evaluate quality and duration of analgesia in the management of patients. Materials and Methods: Thirty patients undergoing abdominal surgeries were equally divided into two groups. Group-I received ropivacaine (0.2%) and Group-II received ropivacaine (0.2%) along with fentanyl (1 mcg/kg) as transversus abdominal block. Patients with stable hemodynamic parameters, American Society of Anesthesiologists grade I and II, and undergoing elective procedures were included in the study. Patients with significant comorbidities and emergency procedures were excluded. Vitals were recorded intraoperatively and subsequent to the procedure. Visual analog scale was recorded at 2nd, 4th, 12th, and 24th h postoperatively. Results: The hemodynamic parameters including blood pressure and heart rate were similar in both the groups with nonsignificant difference. Time to rescue analgesia in the form of injection tramadol was significantly earlier in the group that received ropivacaine alone. Patients receiving ropivacaine significantly had a higher severity pain at all the time points. No serious adverse events were noted in the either of the groups. Conclusion: TAP block using ropivacaine along with fentanyl may provide a higher quality of analgesia in patients undergoing abdominal surgeries in postoperative period.