Intraoperative Ultrasound-guided Transversus Abdominis Plane Block in Lower Abdominal Surgery

Abstract

Background: Ultrasound-guided transversus abdominis plane (TAP) block has been used for analgesia in lower abdominal surgery. In the literature, there are inconsistent reports regarding the efficacy of TAP block in different open abdominal procedures. Therefore, we conducted this prospective randomised doubleblind study to evaluate the pattern of perioperative analgesia and to validate the efficacy of TAP block in patients undergoing lower abdominal surgery. Methods: Thirty-two patients scheduled to undergo lower abdominal surgery (open appendectomy or inguinal hernia repair) under general anaesthesia (GA) were randomly allocated into two groups (each 16 patients) according to pain relief modality used intraoperatively. Group I patients received GA and group II received GA followed by ultrasound-guided TAP block after induction of anaesthesia. Unilateral ultrasoundguided TAP block was achieved with 12 ml of 0.5% bupivacaine. Haemodynamic changes and total dosages of intraoperative analgesics used were recorded intraoperatively. Postoperative pain was assessed using numeric rating score. The total dosages of postoperative analgesics were recorded. Paired student t-test was used to analyze heart rate and blood pressure variations, and Mann-Whitney U test was used to compare analgesic requirement and pain score. P 0.0001]. Postoperative use of meperidine was significantly reduced in group II compared to group I [mean; 7.5 (13.4) vs 46.2 (8) mg; P > 0.0001]. The numeric rating score was significantly lower in group II compared with group I [mean (SD)—0.75 (1.4) vs 5 (1.4)—P > 0.0001]. Conclusion: Ultrasound-guided TAP block is an effective method of providing analgesia during the intraoperative and immediate postoperative period for patients undergoing lower abdominal surgery.