Postoperative Analgesic Efficiency of Transversus Abdominis Plane Block with and without Magnesium Sulphate after Surgical Repair of Moderate Size Umbilical Hernia

Abstract

Abstract Background The transversus abdominis plane (TAP) block is a known approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. Different adjuvants have been used to intensify the quality and the duration of local anesthetics. Aim of the Work The aim of this study is to detect the efficacy and safety of magnesium sulphate as an adjuvant to the analgesia offered by local anesthetic in ultrasound guided TAP block in patients undergoing surgical repair of moderate sized umilical hernia under general anathesia. As regard postoperative pain and opioid consumption using Visual Analogue scale VAS. Patients and Methods the study was carried out on 40 patients who was undergo surgical hernial repair, after ethical approval of Ain Shams University Hospital and informed consent from patients ,patients assigned in two group ,each group include 20 patients, Group 1: receive TAP block with Bupivacaine 0.25% 20 ml per side. Group 2: receive TAP block with Bupivacaine 0.25% 18 mL+2 ml magnesium sulphate. Results By the end of our study we found that VAS pain score was less in group II than in group I at 0,1,2 and 24 hours postoperatively and most significant at 4,6 and 12 hours the VAS score less in group II than group I (p value <0.05).And the mean time for first rescue analgesic dose was delayed in group II (872.87±265.25mins) compared to group I(466.54±118.29mins) (p value <0.001). Conclusion MgSO4 as an adjuvant to Bupivacaine in Ultra-sounded guided TAP block reduces postoperative pain scores, prolong the duration of analgesia and decreases demand for rescue analgesics.