The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy
Carney, John McDonnell, John G. Ochana, Alan Bhinder, Raj Laffey, John G.
Carney, John
McDonnell, John G.
Ochana, Alan
Bhinder, Raj
Laffey, John G.
Repository DOI
Publication Date
2008-12-01
Type
Article
Downloads
Citation
Carney, John; McDonnell, John G. Ochana, Alan; Bhinder, Raj; Laffey, John G. (2008). The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesthesia & Analgesia 107 (6), 2056-2060
Abstract
BACKGROUND: Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial. METHODS: Fifty females undergoing elective total abdominal hysterectomy were randomized to undergo TAP block with ropivacaine (n = 24) versus placebo (n = 26) in addition to standard postoperative analgesia comprising patient-con trolled IV morphine analgesia and regular diclofenac and acetaminophen. All patients received a general anesthetic and, before surgical incision, a bilateral TAP block was performed using 1.5 mg/kg ropivacaine (to a maximal dose of 150 mg) or saline on each side. Each patient was assessed postoperatively by a blinded investigator in the postanesthesia care unit and at 2, 4, 6, 12, 24, 36, 48 h postoperatively. RESULTS: The TA P block with ropivacaine reduced postoperative visual analog scale pain scores compared to placebo block. Mean (+/- SD) total morphine requirements in the first 48 postoperative hours were also reduced (55 +/- 17 mg vs 27 +/- 20 mg, P < 0.001). The incidence of sedation was reduced in patients undergoing TAP blockade. There were no complications attributable to the TAP block. CONCLUSIONS: The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared to placebo block up to 48 postoperative hours after elective total abdominal hysterectomy.
Funder
Publisher
Ovid Technologies (Wolters Kluwer Health)
Publisher DOI
10.1213/ane.0b013e3181871313
Rights
Attribution-NonCommercial-NoDerivs 3.0 Ireland