Effectiveness of Transversus Abdominis Plane Block using Ropivacaine for Postoperative Analgesia in Total Abdominal Hysterectomy Patients.

ABSTRACT

Background: Transversus abdominis plane (TAP) block is a safe, simple and effective technique of providing analgesia for below umbilical surgeries with easily identifiable landmarks. The study is done to study the analgesic efficacy and side effects of TAP block in total abdominal hysterectomy (TAH) patients using below umbilical incision. Methods: a prospective randomized control trial was performed.A bilateral TAP block was performed using 0.25% ropivacaine 1mg/kg in study group (T) using 22G needle, while in control TAP block was not given. The time taken to request for the first rescue analgesic, total consumption of tramadol and antiemetic in 48hrs,visual analog score (VAS) for 6, 12,24, 48 hr postoperatively.The results were analyzed with SPSS 21 software.A P value <0.05 was considered significant. Student t test/Mann Whitney U test were used to find the significance. Results: In Group T, the time to the first dose of rescue analgesic (20.9 + 4.12) was significantly more (p = 0.001) compared to group C (3.55 + 0.44). The total amount of tramadol consumption in 48 hrs in group T (175 + 25.2) was statistically significant (P=0. 001) compared to group C (291 + 24.1) The 48 HR analgesic requirement (11.52 + 2.8) (P=0. 001) and VAS at 6,12,24 and 48 h 0.00 (0-1), (2.4 + 0.8), (2.6 + 1.4), (1.8 + 0.75) respectively were less in the Group T compared to group C.Conclusion: Transversus abdominis plane block proved to be an effective means of postoperative analgesia for TAH patients with minimal sideeffects.