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

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    Date
    2008-12-01
    Author
    Carney, John
    McDonnell, John G.
    Ochana, Alan
    Bhinder, Raj
    Laffey, John G.
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    Cited 295 times in Scopus (view citations)
    
    Recommended Citation
    Carney, John; McDonnell, John G. Ochana, Alan; Bhinder, Raj; Laffey, John G. (2008). The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesthesia & Analgesia 107 (6), 2056-2060
    Published Version
    http://pdfs.journals.lww.com/anesthesia-analgesia/2008/12000/The_Transversus_Abdominis_Plane_Block_Provides.46.pdf?token=method|ExpireAbsolute;source|Journals;ttl|1506152360148;payload|mY8D3u1TCCsNvP5E421JYK6N6XICDamxByyYpaNzk7FKjTaa1Yz22MivkHZqjGP4kdS2v0J76WGAnHACH69s21Csk0OpQi3YbjEMdSoz2UhVybFqQxA7lKwSUlA502zQZr96TQRwhVlocEp/sJ586aVbcBFlltKNKo+tbuMfL73hiPqJliudqs17cHeLcLbV/CqjlP3IO0jGHlHQtJWcICDdAyGJMnpi6RlbEJaRheGeh5z5uvqz3FLHgPKVXJzdOHIHwDOSay4QvwGGy628k/6WDDPgbgZrNKTp2njDaNJZkPLbE7bb6Mu2fGJHW4YH;hash|5siWz0oyx6B4h7ZGICxHoA==
    Abstract
    BACKGROUND: 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. METHODS: 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-con trolled 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. RESULTS: The TA P 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. CONCLUSIONS: 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.
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    http://hdl.handle.net/10379/10701
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