Korean J Anesthesiol.  2011 Nov;61(5):413-418. 10.4097/kjae.2011.61.5.413.

Preemptive analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing gynecologic surgery via a transverse lower abdominal skin incision

• Shin HJ
• Kim ST
• Yim KH
• Lee HS
• Sim JH
• Shin YD

• KMID: 2092324
• DOI: http://doi.org/10.4097/kjae.2011.61.5.413

Abstract

BACKGROUND
The transversus abdominis plane block is recently described peripheral block to providing analgesia to the anterior abdominal wall. The goal of this study is to evaluate the analgesic efficacy of the ultrasound-guided transversus abdominis plane block (US-TAP block) in patients undergoing gynecologic surgery via a transverse lower abdominal skin incision.
METHODS
Thirty-two patients undergoing gynecologic surgery were randomized to undergo standard care such as PCA, or to receive additional US-TAP block with standard care. After general anesthesia induction, a bilateral US-TAP block was performed using 0.375% ropivacaine 20 ml on each side. Postoperative demand of rescue analgesics in PACU and ward were recorded. Each patient was assessed postoperatively by a blinded investigator in the postanesthesia care unit (PACU) and at 2, 6, 10, 24, 48 hr postoperatively to investigate pain, drowsiness, nausea and itch.
RESULTS
The US-TAP block reduced pain intensity compared to standard care in the PACU (5.2 +/- 3.1 vs 8.4 +/- 1.3) and at 2, 24 postoperative hours (3.0 +/- 2.4 vs 5.2 +/- 2.4, 0.9 +/- 1.5 vs 2.2 +/- 1.9). Fentanyl requirements in PACU was reduced (20.3 +/- 20.9 vs 62.5 +/- 35.4 microg, P < 0.05). In ward, pethidine requirements was reduced (21.9 +/- 28.7 vs 56.3 +/- 34.8 mg, P < 0.05).
CONCLUSIONS
The US-TAP block with standard care provide more effective analgesia after gynecologic surgery via a transverse lower abdominal skin incision.

Keyword

Anesthesia; Nerve block; Ultrasonograpy

MeSH Terms

Abdominal Wall
Amides
Analgesia
Analgesics
Anesthesia
Anesthesia, General
Female
Fentanyl
Gynecologic Surgical Procedures
Humans
Meperidine
Nausea
Nerve Block
Passive Cutaneous Anaphylaxis
Research Personnel
Skin
Sleep Stages
Amides
Analgesics
Fentanyl
Meperidine