Evaluation of USG Guided Transversus Abdominis Plane Block for Post- Operative Analgesia in Total Abdominal Hysterectomy Surgeries

Introduction and aims: Transversus abdominis plane (TAP) block is a fascial plane block providing postoperative analgesia in patients undergoing surgery with infraumbilical incision. This single blind prospective randomized control study aimed to evaluate the effectiveness of the TAP block for postoperative pain, as part of a multimodal analgesic regimen in patients undergoing TAH. Material and methods: Sixty adult female patients undergoing Total Abdominal Hysterectomy (TAH) under general anaesthesia were randomizedto undergo TAP block with Ropivacaine along with intravenous paracetamol and diclofenac in group I (n=30) verses group II (n=30) with intravenous paracetamol and diclofenac alone. All patients were given inj.paracetomol 1gm infusion and inj.diclofenac 75 mg intravenously along with induction of anaesthesia. Group I patients additionally received ultrasound guided TAP Block bilaterally with Ropivacaine (0.25%) (25 ml on either side). Each patient was accessed separately by blinded observer at regular intervals upto 24 h for visual analogue scale (VAS), analgesic requirement, PONV and level of sedation using Ramsay sedation scale. If patients complained of pain or VAS>3, inj.Morphine 0.1 mg/kg was given. The observation in two groups was compared statistically using chi-square test and Paired t-test and analysed by SPSS version 18 software. Result: Result showed that the mean visual analogue score (VAS) of group1 was statistically less than group 2 (P<0.001). Mean analgesic requirement in mg for first 24 h postoperatively was significantly less in group 1 (5.40 ± 3.701) than group 2 (9.40 ± 3.856). Conclusion: TAP Block is easy to perform under ultrasound guidance without complication and it provides effective analgesia. TAP Block is effective holds good as a part of multimodal analgesia regimen for patients undergoing Total Abdominal Hysterectomy.