Efficacy of Transversus Abdominis Plane Block for Postoperative Analgesia in Different Lower Abdominal Surgeries in a Tertiary Care Hospital-Chengalpattu District.

Background: Transversus abdominis plane (TAP) block is one of the novel approaches and an effective method for providing postoperative analgesia in patients undergoing lower abdominal surgeries.

Objectives: To evaluate the efficacy and routine usage of TAP block for postoperative analgesia in different lower abdominal surgeries.

Methods: It is a randomized, double-blind trial. Sixty patients undergoing lower abdominal surgeries in sub-arachnoid block with bupivicaine 0.5% were randomized to undergo TAP block (n = 30) using ropivacaine 0.375% as the study group. In the control group (n = 30), only the standard analgesic regimen (paracetamol 1 gm IV and tramadol 50 mg IV) was given. Postoperative pain was assessed using Visual Analogue Scale (VAS) at 30 min and 4, 8, 12, 16, 20, and 24 hrs. First analgesic request after TAP block was compared with a subsequent number of analgesics given postoperatively. Rescue analgesia given postoperatively at request after TAP block was paracetamol 1 gm IV and tramadol 50 mg IV.

Results: Patients who received TAP block had a significant reduction in postoperative pain scores at 30 min - 0 (0 - 1), 4 hrs - 0 (0 - 4), 8 hrs - 4 (3 - 5), 12 hrs - 1 (0 - 4), 16 hrs - 1 (1 - 2), 20 hrs -1 (0 - 2), 24 hrs -1 (0 - 1) with P-value < 0.05 in the first 24 hrs. TAP block also delayed the first rescue analgesic request (265 ± 24 min Vs. 66 ± 15 min with P-value < 0.005) and reduction in subsequent analgesic requirements in the first 24 hrs (1.04 ± 0.26 Vs. 2.3 ± 0.48 with P-value < 0.05).

Conclusions: TAP block holds a considerable part in postoperative analgesia. Highly effective for the first 24 hrs in patients undergoing different lower abdominal surgeries, it delays the first rescue analgesic request, decreases the subsequent analgesic requirement, and augments early mobilization, discharge, and cost-effectiveness.