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The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy

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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-controlled 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 TAP 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. Copyright © 2008 International Anesthesia Research Society.

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APA

Carney, J., McDonnell, J. G., Ochana, A., Bhinder, R., & Laffey, J. G. (2008). The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesthesia and Analgesia, 107(6), 2056–2060. https://doi.org/10.1213/ane.0b013e3181871313

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