Abstract
Objectives: To describe the practice of ultrasound-guided TAP in the management of postoperative pain after gyneco-obstetric surgery. Methods: This was a descriptive prospective study carried out at the Gynecology-Obstetrics department of the Ignace Deen National Hospital over a period of three (03) months from February 01, 2020 to April 31, 2020. Results: In total, we collected 95 patients. These patients had a mean age of 30 ± 9.5 years. The ASA I class was the most represented with 76% of the cases and the cesarean was the most performed intervention. Regarding the assessment of the pain score by the simple verbal scale (SVE) postoperatively at rest, the mean SLE scores at H6 were 0.17 ± 0.38; at H12 of 1.15 ± 0.62; at H24 of 0.84 ± 0.51; at H36 0.45 ± 0.52 and at H48 0.09 ± 0.29. On mobilization, the mean pain scores were 0.77 ± 0.51 at H6, at H12 1.89 ± 0.61; at H24 of 1.53 ± 0.56; at H36 of 1 ± 0.29 and at H48 of 0.82 ± 0.44. The majority of our patients (66.3%) had a mobilization time of less than 24 hours. The mean length of stay was 3.1 ± 1.3 days and most patients (82%) were satisfied with the management of their pain by ultrasound-guided TAP block. Conclusion: Ultrasound-guided TAP is an effective technique for the management of postoperative pain in gyneco-obstetrics surgery. Its integration in a context of multimodal analgesia could improve the management of postoperative pain in gynecological obstetrics.
Highlights
Obstetric and gynecological surgery is the cause of severe to maximum postoperative pain (PDO) during the first 48 hours after surgery
A study carried out in India by Jadon A. et al [5] in 2018 on the role of ultrasound-guided TAP block as a component of a multimodal analgesic regimen for cesarean sections showed that ultrasound-guided TAP block reduces the intensity of pain and decreases the need for additional opioid analgesics when it is used in the multimodal analgesia protocol for pain relief after obstetric surgery
The objective of this study is to describe the practice of ultrasound-guided TAP in the multimodal analgesic management of PDO after gyneco-obstetric surgery in the Gynecology-Obstetrics department of the Ignace Deen National Hospital
Summary
Obstetric and gynecological surgery is the cause of severe to maximum postoperative pain (PDO) during the first 48 hours after surgery. Other analgesia methods such as abdominal wall blocks have been shown to be effective in managing this pain. Among these blocks, the transversus abdominis plane block (TAP block) occupies a special place [3]. Another study carried out in Gabon by Mandji L. et al [2] in 2017 on the efficacy of ultrasound-guided transversus abdominis plane block in cesarean analgesia reported that ultrasound-guided TAP block provides quality analgesia after cesarean section and may be an attractive alternative to morphine.
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