Efficacy of ultrasound-guided transversus abdominis plane block in laparoscopic hysterectomy. Clinical trial

Abstract

Abstract Objectives Transversus abdominis plane block is a regional anaesthesia technique that has proven to be effective for postoperative pain reduction in different abdominal surgical procedures. This study evaluated its efficacy on post laparoscopic hysterectomy pain intensity and analgesic consumption. Methods Randomized controlled trial which included 40 patients scheduled for laparoscopic hysterectomy, enrolled in 2 groups: transversus abdominis plane block + systemic analgesia (Group 1; n = 20) versus systemic analgesia (Group 2; n = 20). Opioid consumption within the first 24 postoperative hours, pain intensity scores at 60 min, 2, 8 and 24 h after surgery, adverse events related to systemic analgesia and time to hospital discharge were evaluated and registered. Results We found no differences between both groups in opioid consumption (10 mg vs. 7 mg; p = 0.2) and pain scores (NVS) within the first 24 postoperative hours, at 60 min (3 vs. 5; p = 0.65), 120 min (0 vs. 2; p = 0.15), 8 and 24 h (0 vs. 0; p > 0.50) for the last 2 points in time analysed. Adverse events related to medication and time to hospital discharge showed similar results. Conclusion Adding a transversus abdominis plane block technique to opioid PCA does not seem to improve postoperative pain management in laparoscopic hysterectomy. Patient preparation time and costs could be incremented and complications (although rare) related to the technique could appear.