Comparative Study between Ultrasound Guided Oblique Subcostal Transversus Abdominis Plane Block and Local Wound Infiltration as Postoperative Analgesia in Hepatectomy

Abstract

oorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and incrase the requirement for rescue analgesics. Appropriate pain treatment protocols to reduce postoperative morbidity, improve the results of the surgery and decrease hospital costs. The analgesic regimen needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of trauma –induced nociceptive impulses. In order to blunt the autonomic and somatic reflex responses to pain and to enhance subsequent restoration of the function of different body-organs as breathing, coughing, and moving easily, together with resumption of oral feeding, and early hospital discharge, Many studies have been carried out trying to find a solution for these dilemma thus different pain modalities as local infiltration of the surgical field, systemic analgesia (narcotics and non-narcotics), neuro-axial blocks, and nerve blocks shined out, however each has shown its side effect which limits its use to specific cases.