Comparison of Ultrasound Guided Transversus Abdominis Plane Block versus Intravenous Patient Controlled Analgesia for Post-Operative Analgesia in Patients Undergoing Lower Abdominal Surgeries under Spinal Anesthesia

Abstract

Abstract Background poorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and increase the requirement for rescue analgesics. Aim of the Work to compare the efficacy of TAP block versus PCA with IV morphine to provide prolonged post-operative analgesia; secondary objective is to identify the side effects of both techniques as post-operative analgesia Patients and Methods The study was conducted on 40 randomly chosen patients aged 21 to 70 years in both sexes, American Society of Anesthesiologists (ASA) class I or II scheduled for elective lower abdominal surgeries under spinal anesthesia in Ain Shams University Hospitals after approval of the medical ethical committee. Results TAP block is given in the volume of 20 mL bilaterally, it is as effective as intravenous Morphine PCA in pain treatment, but with less systemic side effect Also TAP block delay using of postoperative additional analgesia, however PCA analgesic effect last longer, less invasive technique and easier to be used while TAP require hand skills and limited to 24 hours analgesia only. Conclusion In lower abdominal surgery, when TAP block is given in the volume of 40 mL, it is as effective as intravenous PCA in pain treatment. Compared with intravenous PCA, TAP block can be considered as a more preferable method because it can avoid the systemic actions of morphine.