Ultrasound‑guided Posterior Transversus Abdominis Plane Block versus Epidural Analgesia for Postoperative Pain Relief in Lower Abdominal Surgeries

Arnab Das ； Kunal Tiwari ； Sanjay Kumar Sharma ； Shalendra Singh ； Subhasish Patnaik ； Nimish Gaur

《Journal of Medical Sciences》 43卷2期 (2023/04) Pp. 74-78

https://doi.org/10.4103/jmedsci.jmedsci_11_22

摘要

Background: Among the regional anesthesia techniques used for postoperative analgesia for lower abdominal surgeries, epidural analgesia (EA) has been the gold standard and time‑tested technique, but complications and contraindications for the same warrant the need for other equally good analgesic techniques. Aim: The present study compared posterior transversus abdominis plane (TAP) block to EA for postoperative analgesic efficacy in patients undergoing lower abdominal surgeries. Methods: Prospective, observational study in patients undergoing lower abdominal surgeries under general anesthesia. Patients received ultrasound‑guided (USG) 20 ml 0.2% ropivacaine each side in TAP block (Group A, n = 50) or 10 ml of 0.2% ropivacaine was administered in epidural (Group B; n = 50) before extubation. The Visual analog scale (VAS) score, hemodynamic parameters, and ill effects were recorded. Results: The blood pressure was significantly lower in first 6 h of block in Group B. VAS score was significantly lower in Group A in first 6 h of surgery. It was observed that a significantly higher number of patients in the Group B required rescue analgesic and at higher dosages. Postoperative nausea and vomiting were found in 32% of Group B and 22% of Group A patients. Conclusion: TAP block has almost no complications, keeps the patient more hemodynamically stable, and offers a better early postoperative analgesia when compared to EA in patients undergoing lower abdominal surgeries.

關鍵字

Transversus abdominis plane block ； epidural analgesia ； postoperative analgesia ； ropivacaine ； visual analogue score ； ultrasound