The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.
Carney, John McDonnell, John G Ochana, Alan Bhinder, Raj Laffey, John G
Carney, John
McDonnell, John G
Ochana, Alan
Bhinder, Raj
Laffey, John G
Advisors
Editors
Other Contributors
Departments
Department of Anaesthesia, Clinical Sciences Institute, National University of Ireland, Galway, Ireland.
Date
2008-12
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adult
Aged
Double-Blind Method
Female
Humans
Hysterectomy
Middle Aged
Nerve Block
Pain, Postoperative
Aged
Double-Blind Method
Female
Humans
Hysterectomy
Middle Aged
Nerve Block
Pain, Postoperative
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.
Fifty females undergoing elective total abdominal hysterectomy were randomized to undergo TAP block with ropivacaine (n = 24) versus placebo (n = 26) in addition to standard postoperative analgesia comprising patient-controlled IV morphine analgesia and regular diclofenac and acetaminophen. All patients received a general anesthetic and, before surgical incision, a bilateral TAP block was performed using 1.5 mg/kg ropivacaine (to a maximal dose of 150 mg) or saline on each side. Each patient was assessed postoperatively by a blinded investigator in the postanesthesia care unit and at 2, 4, 6, 12, 24, 36, 48 h postoperatively.
The TAP block with ropivacaine reduced postoperative visual analog scale pain scores compared to placebo block. Mean (+/-SD) total morphine requirements in the first 48 postoperative hours were also reduced (55 +/- 17 mg vs 27 +/- 20 mg, P < 0.001). The incidence of sedation was reduced in patients undergoing TAP blockade. There were no complications attributable to the TAP block.
The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared to placebo block up to 48 postoperative hours after elective total abdominal hysterectomy.
Fifty females undergoing elective total abdominal hysterectomy were randomized to undergo TAP block with ropivacaine (n = 24) versus placebo (n = 26) in addition to standard postoperative analgesia comprising patient-controlled IV morphine analgesia and regular diclofenac and acetaminophen. All patients received a general anesthetic and, before surgical incision, a bilateral TAP block was performed using 1.5 mg/kg ropivacaine (to a maximal dose of 150 mg) or saline on each side. Each patient was assessed postoperatively by a blinded investigator in the postanesthesia care unit and at 2, 4, 6, 12, 24, 36, 48 h postoperatively.
The TAP block with ropivacaine reduced postoperative visual analog scale pain scores compared to placebo block. Mean (+/-SD) total morphine requirements in the first 48 postoperative hours were also reduced (55 +/- 17 mg vs 27 +/- 20 mg, P < 0.001). The incidence of sedation was reduced in patients undergoing TAP blockade. There were no complications attributable to the TAP block.
The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared to placebo block up to 48 postoperative hours after elective total abdominal hysterectomy.
Language
en
ISSN
1526-7598
eISSN
ISBN
DOI
10.1213/ane.0b013e3181871313
PMID
19020158