Abstract PR482

Abstract

Background & Objectives: Ultrasound (US) guided transversus abdominis plane (TAP) block is a proven postoperative analgesic technique after lower abdominal surgeries. Spread of drug in the TAP is an important consideration influencing the block. Addition of hyaluronidase to local anaesthetic,bupivacaine may improve quality of analgesia. Materials & Methods: US guided TAP block was performed before extubation on 60 consenting adult patients undergoing unilateral inguinal hernia repair under general anaesthesia. After randomization, 30 patients received bupivacaine 0.25% (19ml) with normal saline (1ml) (Group A) and 30 patients received bupivacaine 0.25% (19ml) with hyaluronidase 1500U (1ml) (Group B)with double blinding. Sample size of 30 each was based on assumption of 20% improvement in quality of blockade in Group B. Pain was assessed using numeric rating scale (NRS) at rest, movement and cough from 10th minute to 24 hours. Duration of analgesia, need for rescue analgesic and 24 hour tramadol consumption and others were noted. Results: Patients were comparable with respect to baseline characteristics. NRS on cough was low in Group B from 10th minute to 24 hours(P<0.05). NRS on movement was significantly low from 2nd to 24th hour(P<0.05) in group B. 24 hour tramadol consumption was comparable in both groups.Conclusion: The addition of hyaluronidase was associated with significant reduction of NRS at cough, and may be attributed to the improved quality of analgesia as a result of increased spread due to hyaluronidase.