Ultrasound-guided transversus abdominis block as part of multimodal analgesia In comparison with systemic morphine during laparoscopic operations

Background Transversus abdominis plane (TAP) block is a regional anesthetic technique that blocks the abdominal wall neural afferents by introducing local anesthetic into the neurofascial plane between the internal oblique and transverses abdominis muscles. Randomized controlled trials have demonstrated the efficacy of TAP block as a component of a multimodal regimen, in providing postoperative analgesia after abdominal surgery. Methods :80 patients undergoing laparoscopic surgery were randomized to receive standard general anaesthesia either with ( Group A, n 40 ) or without TAP block ( Group B, n 40 ). Ultrasound-guided bilateral TAP block was performed with a high frequent linear ultrasound probe and an in-plane needle technique with 15 ml plain bupivacaine 0.5 % on each side. Intraoperative , postoperative demand of morphine were recorded and complications also were recorded in 1 24 hours. Results :80 patients were randomized for this study . Divided into two groups according to use of ultrasound guided transversus abdominis block or systemic morphine analgesia . Intraoperative morphine use is lower number of patients in group A than group B which statistcally highly significant ( p value = 0.00003 ) and total opioid dose in mg used in recovery area was lower in group A compared to group B which show highly significant value ( p value = 0.0001) also total 24 morphine is significantly lower in ultrasound group A than group B ( p value = 00001) . Conclusions. :ultrasound-guided TAP block substantially reduced the perioperative opioid consumption and nausea vomiting and respiratory depression with less complications . Keywards : Ultrasonographic guidance , TAP block , Abdominal laparoscopy