To evaluate the efficacy of novel approach to transversus abdominis plane block for postoperative analgesia after abdominal surgeries

Abstract

Introduction: The surgical transversus abdominis plane (TAP) block is a novel approach for postoperative analgesia after abdominal surgeries. The block was given intraperitoneally during the intraoperative period. We evaluated its analgesic efficacy in patients during the first 48 h of the postoperative period after abdominal surgery, in a randomized, controlled, double-blind clinical trial. Materials and Methods: Thirty adult patients undergoing surgery requiring midline abdominal incision were randomized and divided into two groups. Group-T received TAP block with 20 ml of 0.5% bupivacaine intraperitoneally, and Group-P received TAP block with normal saline (placebo). Each patient was evaluated by a blinded investigator in the postanesthesia care unit and at 1, 2, 4, 6, 12, 24, 36, and 48 h. Results: Diclofenac consumption was almost reduced by 50% in TAP group in comparison to placebo group (mean diclofenac requirement of the TAP group vs. placebo group was 110 ± 25 mg and 225 ± 28 mg, respectively; P < 0.0001). Mean time to first request of analgesic was significantly prolonged in TAP block (210 min) as compared to placebo (90 min). Postoperative verbal analog scores at rest and at movement were significantly reduced in TAP block group from 4 to 24 h postoperatively as compared to placebo group. All TAP block patients were quite satisfied with the postoperative analgesic regimen. Conclusion: Postoperative analgesic consumption of diclofenac was almost reduced to half in TAP block group as compared to placebo group, and also, time to first request of analgesic was significantly prolonged in TAP block group. The surgical TAP block is a novel approach for providing postoperative analgesia which is easy to perform, safe and has no adverse effects.