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    The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

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    Authors
    Carney, John
    McDonnell, John G
    Ochana, Alan
    Bhinder, Raj
    Laffey, John G
    Affiliation
    Department of Anaesthesia, Clinical Sciences Institute, National University of Ireland, Galway, Ireland.
    Issue Date
    2008-12
    MeSH
    Adult
    Aged
    Double-Blind Method
    Female
    Humans
    Hysterectomy
    Middle Aged
    Nerve Block
    Pain, Postoperative
    
    Metadata
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    Citation
    The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. 2008, 107 (6):2056-60 Anesth. Analg.
    Journal
    Anesthesia and analgesia
    URI
    http://hdl.handle.net/10147/127693
    DOI
    10.1213/ane.0b013e3181871313
    PubMed ID
    19020158
    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.
    Item Type
    Article
    Language
    en
    ISSN
    1526-7598
    ae974a485f413a2113503eed53cd6c53
    10.1213/ane.0b013e3181871313
    Scopus Count
    Collections
    Galway University Hospitals

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