Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial

Autor: MS Anusha, K Udaya Bhaskar, Jaganath, T Dharani Priya, Mohan Koyee
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical and Diagnostic Research, Vol 16, Iss 10, Pp UC17-UC21 (2022)
Druh dokumentu: article
ISSN: 2249-782X
0973-709X
DOI: 10.7860/JCDR/2022/59195.17016
Popis: Introduction: Pain relief postoperatively has advantages related to better patient satisfaction in terms of early ambulation and discharge and also better cardiovascular stability, decreased infections, neurological complications, prevention of thromboembolic phenomenon, and chronic pain syndrome. Non Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are the most commonly used drugs in pain management. Transverse Abdominis Plane (TAP) block is a regional analgesic technique, which provides analgesia of the anterolateral abdominal wall and hence can be used to provide analgesia for caesarean section, hernia repairs, hysterectomies, cholecystectomy. Aim: To compare the effectiveness of bilateral TAP block versus port sites local anaesthetic infiltration to relieve postoperative pain in laparoscopic gynaecological surgeries. Materials and Methods: This single-blinded randomised clinical study conducted at PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India, from January 2020 to June 2021. The clinical trial was conducted on 80 patients belonging to American Society of Anaesthesiologist (ASA) I and II posted for elective laparoscopic gynaecological surgeries. Patients were randomly allocated into two groups with 40 patients in each group. Group T (TAP block) received 0.6 mL/kg of 0.25% bupivacaine for bilateral ultrasound guided TAP block and group O (port sites local infiltration) received 0.6 mL/kg of 0.25% bupivacaine for port sites infiltration. At the end of surgery, patients received either TAP block or port site infiltration as per the group allocated and then extubated. Postoperative pain intensity using Visual Analogue Scale (VAS) score were recorded at the time of shifting as 0 hr and then every 2 hrs, 4 hrs, 6 hrs, 8 hrs, 12 hrs and 24 hrs. The mean time for first rescue analgesia and total number of rescue analgesic given in first 24 hrs were noted. Haemodynamic parameters and side-effects with study drug were noted. For inferential statistics, numerical data was analysed by Chi-square test and for categorical data student’s t-test was used. A p-value
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