Efficacy of transversus abdominis plane (tap) block for intraoperative and postoperative analgesia in patients undergoing abdominal hysterectomy under general anaesthesia- a randomised controlled study

Background: To evaluate the effect of transversus abdominis block for intra and post-operative analgesia in patients undergoing abdominal hysterectomy under general anaesthesia.Methods: Prospective, double-blind, randomized, clinical study on 80 patients of age 40-60 years undergoing total abdominal hysterectomy under general anaesthesia. Patients were randomly divided into 2 equal groups; Group N (n=40): TAP block with 30 ml of normal saline; Group B (n= 40): TAP block with 30 ml of 0.25% bupivacaine. All patients were given general anaesthesia followed by transversus abdominis plane block (TAP). All parameters like postoperative VAS Score, intraoperative haemodynamic changes (HR, SBP, DBP, MAP) were recorded. In the postoperative period diclofenac 1.5 mg/kg was given. If VAS ≥ 4 inj tramadol 2mg/kg i.v. was given as rescue analgesia. Total dose of diclofenac and tramadol in 24 hr post operative period was recorded.Result: The time for first analgesic request was increased in Group B 134.67±16.23 min  as compared to Group N 42.85±18.13 min  (P value  <0.05). Maximum VAS score up to 24 hrs postoperative was lower in the Group B (2.77 ± 9.73) as compared to group N (5.6±1.42) (P value <0.05). The rescue analgesic consumption within 24 hours post operatively was lower in Group B (105.75±71.24 mg) compared to Group N (218±40.01 mg) (P value <0.05).Conclusion: TAP block provide significant postoperative analgesia in first 24 hour and excellent hemodynamic stability being a safe modality for intra and post operative analgesia for total abdominal hysterectomy.