Online ISSN: 2515-8260

Keywords : TAP Block


Comparison of analgesic efficacy of 0.25% bupivacaine vs 0.25% bupivacaine with dexmedetomidine in transversus abdominis plane block for postoperative caesarean section

Dr. Prashanthi S, Dr. SK Srinivasan, Dr. Subbulakshmi S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3473-3480

Aim: The aim of the study is to compare post-operative analgesic efficacy of 0.25% bupivacaine vs 0.25% bupivacaine with dexmedetomidine in transversus abdominis plane block for postoperative caesarean section.
Methodology: Prospective randomized double blinded experimental study was conducted among 60 patients posted for elective caesarean section surgery and were divided into two equal groups. Group B patients received 20ml of 0.25% Bupivacaine and Group BD patients received 20ml of 0.25% Bupivacaine with 50 mcg Dexmedetomidine. Visual Analogue Score was used to determine the pain at rest during postoperative period. The time of requirement of rescue analgesia during postoperative period was also assessed.
Results: The demographic variables such as age and sex were comparable between the two groups.VAS at rest was significantly reduced in group BD (p<0.05). Duration of analgesia was significantly prolonged in group BD when compared to group B with significant P value <0.05. Rescue analgesic consumption in 24 hours during postoperative period was significantly decreased in group BD (p<0.05). Intraoperatively the heart rate, systolic and diastolic bp was comparable between both the groups. Postoperatively there was a significant fall in heart rate systolic and diastolic bp in the group BD when compared to group B with a P value <0.05.
Conclusion: In this study we observed that Dexmedetomidine, in combination with bupivacaine when given for TAP block provided excellent postoperative analgesia, extending upto more than 12 hours. Dexmedetomidine seems to decrease postoperative analgesic consumption and improve pain scores.

Comparative Study of Pre-Operative Ultrasound Guided Transversus Abdominis Plane Block Versus Post-Operative Ultrasound Guided Transversus Abdominis Plane Block on Perioperative Hemodynamic Status and Post-Operative Analgesic Requirement in Patients Undergoing Laparoscopic Abdominal Surgeries

Bhanushree G, Priyanka Krishnamurthy, P K Dileep, Soumya Rohit

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2781-2789

Background:Although abdominal laparoscopic surgery is known for less pain compared with that of laparotomy, many patients still complain considerable post-operative pain. Pneumoperitoneum affects several homeostatic systems leading to alteration in cardiovascular, pulmonary physiology and stress response. The benefits of an adequate analgesia include a reduction in stress response of surgery, reduction in   perioperative morbidity and effective pain control can also facilitate rehabilitation and accelerates recovery from surgery.
Materials and Methods: This is a Randomized control study and single blind study conducted at Done in Hospitals attached to Bangalore Medical College and Research Institute, Bangalore over 10 months -from November 2019 to September 2020. Patients undergoing laparoscopic abdominal surgeries admitted to hospital.  Group I (n=40) –will receive ultrasound guided transversus abdominis plane block prior to surgical procedure (starting with skin incision). Group II(n=40) –will receive ultrasound guided transversus abdominis plane block after surgery (following skin suture and closure).
Results: The two groups were comparable in terms of age, sex, weight, ASA grading, mean duration of surgery, mean duration of anesthesia and mean duration of insufflations. The two groups were comparable in terms of intraoperative EtCO2 and respiratory rate. Comparison of heart rate at regular intervals with basal heart rate, P value was significant from 45 minutes to 90 minutes in both the groups. Comparison of SBP at regular intervals with basal SBP, the difference was not statistically significant from 30 minutes to 75 minutes in group I, while the difference was statistically significant in group II. In comparison of DBP at regular intervals with basal DBP, the difference was not statistically significant at intervals of 45 to 90 minutes in both the groups. In comparison of MAP at regular intervals with basal MAP, the difference was not statistically significant at intervals from 30 to 90 minutes in both the groups (Table 4).
Conclusion: For patients undergoing laparoscopic surgery, preoperative TAP block was recommended for duration of surgery <180 min for lower consumption of intraoperative opioids, while postoperative TAP block was better than preoperative manipulation for duration of surgery >180 min, which might obtain lower postoperative pain score, less postoperative analgesics, and higher satisfaction score.