A comparative study between Ultrasound Guided Bilateral Transversus Abdominis Plane block Versus Opioids (Nalbuphine) Analgesia after Abdominoplasty

Abstract

: Poorly controlled acute pain after abdominoplasty is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and an increased likelihood of chronic pain. Objectives: The aim of this study is to assess the analgesic efficacy and hemodynamic effects of bilateral ultrasound guided single injection Transversus Abdominis Plane (TAP) Block compared with intravenous nalbuphine after abdominoplasty. Each of them combined with general anesthesia in patients undergoing abdominoplasty. Patients and Methods: The study was conducted on 70 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 35 patients each: Group TAP: bilateral ultrasound guided TAP block was performed before extubation of patients using 20 ml of 0.25% bupivacaine in each side, Group N: received intravenous nalbuphine as post operative analgesia after abdominoplasty. Results: The results of the study revealed that single injection tansversus abdominis plane block has more analgesic efficacy than intravenous nalbuphine. The first call for rescue analgesia (nalbuphine), total nalbuphine consumption and pain scores (visual analog score) indicated that the superiority of the analgesic technique (TAP Block) was attributed to their opioid sparing effect. Conclusion: An ultrasound-guided TAP block technique allows for direct visualization of all anatomical structures, the needle, and the spread of local anesthetic, thereby increasing the safety margin, optimizing block qualities, decreasing systemic analgesia requirements and sparing its side effects.