Comparison between Ultrasound Guided Transversus Abdominis Plane Block and Local Anesthetic Instillation in Patients Undergoing Laparoscopic Hysterectomy

Abstract

Poorly controlled acute pain after abdominal surgery is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain. The analgesic regimen needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of nociceptive impulses. The advantages of TAP block include simple and effective analgesic technique, appropriate for surgical procedures where parietal peritoneum is a significant component of postoperative pain, very minimal complication rate and can be performed even if neuraxial techniques are contraindicated. In this study, 50 female patients scheduled for laparoscopic hysterectomy surgery. They were divided into 2 groups: TAP group: (n=25) patients of this group received TAP block performed by ultrasound guidance and IPLA group (n=25) patients of this group received intraperitoneal local anesthetic (bupivacaine). We found that there was statistically significant difference between two groups according to pain score (VAS), post-operative hemodynamics and postoperative morphine consumption between 2 groups. The mean morphine consumption was 8.36 mg in the TAP group while was 12.24 mg in the IPLA group.