Assessment of Transversus Abdominis Plane Block in Abdominal Surgery by Total Requirement of Diclofenac as a Post-Operative Analgesia Drug

Abstract

Background: Amongst various techniques of TAP block, landmark technique via the triangle of Petit seems to hold considerable promise for patients undergoing surgical procedures involving abdominal wall incisions. The aim of this study is to evaluate transversus abdominis plane [TAP] block in abdominal surgery by total requirement of diclofenac as postoperative analgesia drug.Subjects and Methods:Present study was carried out at Department of Anesthesia, GMERS medical college, Sola, Ahmedabad, Gujarat, India from May 2014 to May 2015. According to formula based nomogram, sample size for proposed study would be: Study group (n=30): patient received TAP block with injection bupivacaine (0.25%) 20 ml. Control group (n=30): patient not received TAP block and was given injection diclofenac on demand for post-operative analgesia as per institute protocol for routine surgery. Sensory block was assessed by sterile pin prick method in the midaxillary line on both sides of chest. Postoperative pain was assessed by using the visual analogue scale.Results:Majority of the patient were in age group of 30 to 50 in both group. VAS score was significantly higher in control group as compared to the study group at all the time. First dose of rescue analgesia required in study group was at 669.66± 346 min and in control group was 220.33 ± 139.24 min which was statistically significant. Diclofenac requirement in study group was one time in 22 patient and two time in 8 patient which was significantly less as compare to control group in which diclofenac requirement was one time in 2 patient and two time in 5 patient and three time in 23 patient in 24 hour.Conclusion:TAP block is a promising new technique for postoperative pain management in surgery involving the anterior abdominal wall as a part of multimodal analgesia. Further studies are warranted to support this finding before establishing it in routine clinical practice in different type of surgical procedures.