Analgesic efficacy of surgeon-assisted transverse abdominis plane block in patients undergoing open cholecystectomy.
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Date
2013-07
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Abstract
Background: Unavailability of ultrasound and unpredictable success with traditional blind technique makes Transversus Abdominis Plane Block under-utilized in developing country like India.
Aims & Objective: The present study was designed to evaluate the analgesic efficacy of Surgeon-assisted Transversus Abdominis Plane Block as an adjuvant to routine analgesic in reducing pain score during first 12 hours postoperatively in patients undergoing open cholecystectomy.
Material and Methods: This was randomized, double-blinded, controlled, clinical trial carried out in tertiary care, teaching hospital. All the patients received a routine general anaesthesia with standard monitoring. Group A received routine analgesic which included Diclofenac sodium 75 mg intravenously (IV) at 8 hourly and group B received routine analgesic & Transversus Abdominis Plane Block with 15 ml of bupivacaine 0.25% at the end of surgery. Visual analogue score for pain, incidence of post-operative nausea and vomiting and demand of rescue opioid (Tramadol 2 mg/kg IV) in post-operative period were assessed every 2 hourly up to 12 hours after the surgery by an investigator blinded to group allocation.
Results: Transversus Abdominis Plane block reduced visual analogue scale for pain on emergence and at all postoperative time points up to 12 hours (p < 0.0009). The incidence of post-operative nausea and vomiting, and demand of rescue opioid in the first 12 postoperative hours were also reduced (p < 0.0001). There were no complications attributable to the block.
Conclusion: Transversus Abdominis Plane Block is effective as an adjuvant to routine analgesic to reduce pain after open cholecystectomy and reduces post-operative opioid demand and nausea & vomiting.
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Keywords
Transversus Abdominis Plane Block, Post-Operative Pain, Bupivacaine, Cholecystectomy
Citation
Parmar Siddharth, Sheikh Abdul Nasir, Vyas Atul, Puri Garima. Analgesic efficacy of surgeon-assisted transverse abdominis plane block in patients undergoing open cholecystectomy. International Journal of Medical Science and Public Health. 2013 ; 2(3): 594-597.