Postoperative analgesic efficacy of transversus abdominis plane block versus lumbar epidural following lower abdominal surgeries

Abstract

Background Transversus abdominis plane (TAP) block represents a rapidly expanding technique. It was reported to significantly reduce pain with lower abdominal surgery. Epidural analgesia is a popular analgesic technique for abdominal operation, with great efficiency and safety. Aim The aim was to evaluate the effect of ultrasound-guided TAP block versus lumbar epidural after lower abdominal surgery analgesia. The primary outcome was to evaluate which technique is more effective regarding postoperative analgesia, and the secondary outcome was to evaluate the amount of rescue analgesia used in both groups. Patients and methods The study was carried out on 70 patients scheduled for a lower abdominal surgery randomly divided into TAP block group and epidural group (35 patients each) and measurement of visual analog score and amount of rescue analgesia used in both groups. Results Visual analog score was significantly lower at 6, 12, 18, and 24 h in the TAP block group in contrast to epidural group, with insignificant difference at postanesthetic care unit and 2 and 4 h between both groups. There was a delayed first analgesic requirement in the TAP block group in contrast to the epidural group, with decrease in the total dose of rescue analgesia in the TAP block group than the epidural group. Conclusion TAP block presents greater effectivity than lumbar epidural block in curing postoperative aches in patients having lower abdominal surgeries regarding pain intensity, time of first analgesic necessity, and total dose of rescue analgesia.