European Journal of Molecular & Clinical Medicine

Femoral thromboembolectomy surgery is on the rise nowadays due to increased number of cardiac interventional procedures. In this Procedure General or spinal anaesthesia is not often favored due to anticoagulants and associated comorbid conditions. Transversus abdominis plane block (TAP Block) may provide a reasonable alternative for this procedure. We present a case series of 16 patients undergoing emergency femoral artery thrombo-embolectomy under TAP block. TAP block was performed using 30 mL of 0.25% Bupivacaine. Block efficacy was graded as complete, partial, and failed block. Complete Block was achieved in seven (44%) patients. Five patients were administered a single bolus of butorphanol intraoperatively, while four patients required two boluses of butorphanol, and this group was categorized as a partial TAP block. None of the patients required general anaesthesia. Thus TAPB can be considered an alternative anaesthesia approach for femoral thromboembolectomy

Aim: To compare the effectiveness of post caesarean section pain relief between transversus abdominis plane block and conventional parenteral opioid analgesia by comparing visual analogue pain scores.
Material and methods: The current study is a prospective randomized interventional studyobservational study. The study was conducted over the period of DNB training for a period of three years. Total 100 patients of American Society of Anesthesiologists (ASA) Grade I and II aged 18 - 45 years scheduled to undergo lower segment caesarean section under spinal anesthesia were included in this study.
Results: It is observed that to compare the effectiveness of post caesarean section pain relief between ultrasound guided transversus abdominis plane block and conventional parenteral opioid analgesia by comparing visual analogue pain scores and total opioid consumption in 24 hours. A total of 100 patients, 50 in each group were included. The distribution of patients according to age between the groups. The mean age of patients of TAP and CONT groups was 25.62±2.19 and 25.64±2.31 years respectively. There was no significant (p>0.05) difference in age between the groups showing comparability of the groups in terms of age. Additionally, the distribution of patients according to ASA grade between the groups. More than half patients of both TAP (74%) and CONT (72%) group had ASA grade I.
Conclusion:This study was carried out to adding transversus abdominis plane block as a part of multimodal analgesia in patients undergoing caesarean section prolonged pain- free duration, decreased VAS pain scores, reduced the number of patients who required rescue analgesicamount of rescue analgesia required was much less in amount and prolonged the time to first request for analgesia.

Background: This study compared the analgesic efficacy of the bilateral erector spinae plane
(ESP) with that of the bilateral transversus abdominis (TAP) postoperative delivery with
selected surgery.
Methods: Sixty mothers scheduled for caesarean section under random surgery were
randomly assigned to receive an ESP block or a TAP block. The ESP group received USG
guided block with 20 mL 0.2% of ropivacaine at the T9 level corresponding to T10 transverse
process e at the end of surgery. The TAP group received an ultrasound-guided TAP block
containing 20 mL of 0.2% ropivacaine at the end of delivery. The main effect was the
duration of analgesia achieved by each block. Measures of the second outcome were
postoperative pain severity, complete diclofenac use, patient satisfaction.
Results: The median duration (interquartile) block was longer in the ESP group than in the
TAP group (12 hours [10-14] vs 8 hours [8-10], p <0.0001). In the first 24 hours, the median
rate of analog pain observed at rest was lower in the ESP group. Intermediate diclofenac use
in the first 24 hours was significantly higher in the TAP group than in the ESP group (125 mg
[100-150] vs 100 mg [75-100, p = 0.003]).
Conclusion: Compared with the TAP block, ESP block provides effective pain relief, has a
long lasting analgesic action, increases duration of first analgesic need, is associated with
minimal diclofenac use, and can be used in multimodal analgesia and opioid -sparing
medication after surgery.

Background: Acute postoperative pain is a major problem, leads to undesirable outcome if not controlled probably. Therefore, appropriate management of acute perioperative pain using multimodal or balanced analgesia is crucial. The aim of the study was to compare between ultrasound guided quadratus lumborum block (QLB) and transversus abdominis plane (TAP) block as postoperative analgesia in lower abdominal surgeries. Patients & Methods: Thirty patients, aged from 21 to 50 years, ASA physical status I or II, scheduled for unilateral lower abdominal surgeries under general anesthesia were randomly divided into two equal groups of fifteen each. QLB group: patients received unilateral QLB block with 30 ml of 0.25% bupivacaine and TAP Group: Patients received unilateral TAP block with 30 ml of 0.25% bupivacaine. All patients in both groups were assessed for: Postoperative Visual analogue score (VAS), time to 1st rescue of analgesia, sensory block assessment (onset, level). In addition, total nalbuphine consumption in the first postoperative 24h and patient satisfaction were also recorded. Results: VAS was significantly higher in patients received TAP block. Patients received QLB showed rapid sensory loss with higher sensory block level in comparison to TAP block group. Time to 1st rescue of analgesia, was delayed in patients received QLB, so, this group showed longer duration of analgesia with higher satisfaction score than TAP group. In addition, the total nalbuphine consumption was higher in the first 24 hours in TAP block group compared to QLB group. Conclusion: The recently introduced QLB, may be a good option for postoperative pain relief after lower abdominal surgery with reduction of opioid consumption, prolonged duration of analgesia, and higher patient satisfaction compared to transversus abdominis plane block. We belief that if US guided QLB is performed by experienced hands; it is safe and effective technique for postoperative analgesia.