Comparison of ultrasound guided transversus abdominis plane (TAP) block by posterior and lateral approach for their analgesic efficacy after lower abdominal surgery
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 1
Abstract
Objective: To compare analgesic efficacy of ultrasound guided transversus abdominis plane (TAP) block by posterior and lateral approach after lower abdominal surgery Material and methods: In this prospective randomized study, adults undergoing elective lower abdomen surgery under spinal anaesthesia with 0.5% bupivacaine received either ultrasound guided lateral TAP or ultrasound-guided posterior TAP block with ropivacaine 0.2% after sensory level receded to T10.Pain severity at rest and movement was assessed at 2, 4, 6, 12 and24 hours using VAS. Amount of tramadol used in first 24 hours after surgery and time of requirement for first analgesic was recorded. Results: Sixty two patients [posterior TAP block (n=31) and lateral TAP block (n=31)] were included. The mean (SD) VAS score at rest for posterior group at 2 hours, 4 hours, 6 hours, 12 hours and 24 hours was 1.9 (+0.5), 2.0 (+0.5), 2.3 (+0.4), 2.7 (+0.4) and 3.2 (+0.5) respectively. Corresponding values for lateral group were 2.2 (+0.7), 2.3 (+0.6), 2.6 (+0.5), 3.6 (+0.5) and 4.1 (+0.3) respectively. VAS score at 2 hours (p=0.0374) and 24 hours (p<0.001) was significantly lower with posterior TAP block than lateral TAP block. Mean VAS score on movement at 12 hours and 24 hours was significantly lower with posterior TAP block than lateral group (p <0.001 for 12 and 24 hours). Time required for first analgesic in posterior group was significantly longer [12.8 (+0.8) vs 7.4 (+0.6) minutes; p<0.001]. Similarly, requirement of tramadol in posterior group was significantly lower [40.3 (52.3) vs 206.5 (99.8); p<0.001]. Conclusion: In patients undergoing lower abdominal surgery, ultrasound guided transversus abdominis plane (TAP) block by posterior approach provides better analgesic efficacy as compared to lateral approach.
Authors and Affiliations
Shailendra Patil, Asmita Karnalkar, Kashinath Jadhav
Keywords
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- EP ID EP589637
- DOI 10.26611/10151015
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