COMPARISON OF ANALGESIC EFFICACY OF TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL LOCAL ANESTHETIC WOUND INFILTRATION

Transversus Abdominis Plane Block

Abstract

Objective: To determine the analgesic efficacy of ultrasound guided transversus abdominis plane block in
comparison to conventional local anesthetic wound infiltration technique in patients undergoing laproscopic
cholecystectomy.
Study Design: Randomized controlled trial.
Place and Duration of Study: Combined Military Hospital Rawalpindi, from Jan 2016 to Jun 2016.
Material and Methods: This study was conducted after approval from the ethical committee. Total of 132
patients, American Society of Anesthesiologists physical status I or II, were randomized to group A and group B
(n=66), received ultrasound guided transversus abdominis plane block on each side and local anesthetic wound
infiltration with 0.5% bupivacaine (1mg/kg). Injection nalbuphine was used as a rescue analgesic if needed.
Mean pain score and total rescue analgesia required were recorded on emergence, then 2 hourly for next 12 hours
postoperatively, in numerical rating scale and in milligram (mg).
Results: Mean pain score at 12 hours postoperatively in group A and group B were 4.01 ± 2.55 and 6.04 ± 2.74
respectively (p-value <0.05). Similarly the mean opiate requirement till 12 hour postoperatively in group A
and group B were 6.39 ± 3.86 (mg) and 9.95 ± 4.62 (mg) (p-value <0.05). Nausea/vomiting were observed in 19
(28.78%) and 31 (46.96%) patients in group A and group B respectively.
Conclusion: Ultrasound guided transversus abdominis plane block has shown to be an effective modality for
providing adequate postoperative analgesia with significantly less post-operative opiate requirement when
compared to local anesthetic wound infiltration.