Comparison of USG guided with Anatomical Landmark guided TAP Block following Total Abdominal Hysterectomy

Abstract

A crucial part of a multimodal anaesthetic strategy utilized to accelerate recovery following lower abdominal procedures is the Transversus Abdominis Plane (TAP) Block. The TAP Block is administered in the petit triangle, with its base being formed by the iliac crest, the external oblique in front of it, and the latissimus dorsi at its rear. The intercostal, subcostal, iliohypogastric, and ilioinguinal nerves are housed in this interfascial plane. The TAP block reduces pain from the incision site during both inpatient and outpatient surgical procedures, as well as open and laparoscopic abdominal operations, by obstructing sensory signals from the nerves providing the anterior wall of the abdomen (anterior division of the segment of the spinal cord responsible for T6-L1). Postoperative pain can be effectively alleviated with TAP blocks. Through the use of supplementary drugs such as opioids, opioid agonist antagonists, ketamine, and alpha-2 agonists, including Nalbuphine, clonidine, and dexmedetomidine in blockade of peripheral nerves and field blocks, the duration of pain relief following surgery can be extended. Specifically, a combination of 10 mg of Nalbuphine and bupivacaine, on either side with a volume of 20 ml, improves patient comfort and pain management, allows for early patient mobilization, prolongs postsurgical pain relief, and lowers the need for rescue analgesia. This research aims to assess the efficacy of the Anatomical Landmark against Ultrasound-Guided TAP Block for patients undergoing Total Abdominal Hysterectomy under Subarachnoid Block.