KUMJ | VOL. 12 | NO. 2 | ISSUE 46 | APRIL-JUNE, 2014
Comparison of Ultrasound Guided Transversus Abdominis Plane Block Versus Local Wound Infiltration for Post Operative Analgesia in Patients Undergoing Gynaecological Surgery Under General Anaesthesia
Ranjit S, Shrestha SK
Abstract: Background
Transversus abdominis plane block has been recently developed as a part of
multimodal post operative analgesic techniques. We compared the analgesic
efficacy of this technique with local bupivacaine infiltration in patients undergoing
gynaecological surgeries with pfannenstiel incision and lower midline incision
under general anaesthesia.
Objectives
To evaluate the efficacy of ultrasound guided transversus abdominis plane block for
postoperative analgesia.
Methods
Patients were randomly allocated to three groups: control group (n=15), transversus
abdominis plane block group (n=15), who received bilateral transversus abdominis
plane blockwith 0.25% bupivacaine, and local infiltration group (n=15), who
received local wound infiltration with 0.25% bupivacaine at the end of surgery. All
patients received intramuscular diclofenac 12 hourly and intravenous tramadol
SOS in the postoperative period. Visual analogue scores for pain were assessed
at 1,2,4,8,12 and 24 hours postoperatively and these were compared between
the three groups. Average tramadol consumption in 24 hours were also compared
among the three groups. Data were subjected to univariate ANOVA test and chisquare
test. Level of significance was set at 0.05.
Results
Visual analogue scores were significantly less in transversus abdominis plane block
group and effect lasted up to 12 hours at rest postoperatively and 8 hours during
cough and movement.
Conclusion
Bilateral Transversus abdominis plane block was effective in reducing postoperative
pain scores for 8 to 12 hours postoperatively. This block was also successful in
reducing postoperative opioid requirement.
Keyword : Postoperative analgesia, transversus abdominis plane block, ultrasound guidance, visual analogue score.
