Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial
Introduction: Pain relief postoperatively has advantages related to better patient satisfaction in terms of early ambulation and discharge and also better cardiovascular stability, decreased infections, neurological complications, prevention of thromboembolic phenomenon, and chronic pain syndrom...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2022-10-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/17016/59195_CE(AnK)_F[SH]_PF1(SC_SS)_PFA(SC_SS)_PN(SS).pdf |
| _version_ | 1828060244444446720 |
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| author | MS Anusha K Udaya Bhaskar Jaganath T Dharani Priya Mohan Koyee |
| author_facet | MS Anusha K Udaya Bhaskar Jaganath T Dharani Priya Mohan Koyee |
| author_sort | MS Anusha |
| collection | DOAJ |
| description | Introduction: Pain relief postoperatively has advantages related
to better patient satisfaction in terms of early ambulation
and discharge and also better cardiovascular stability,
decreased infections, neurological complications, prevention of
thromboembolic phenomenon, and chronic pain syndrome. Non
Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are the
most commonly used drugs in pain management. Transverse
Abdominis Plane (TAP) block is a regional analgesic technique,
which provides analgesia of the anterolateral abdominal wall and
hence can be used to provide analgesia for caesarean section,
hernia repairs, hysterectomies, cholecystectomy.
Aim: To compare the effectiveness of bilateral TAP block versus
port sites local anaesthetic infiltration to relieve postoperative
pain in laparoscopic gynaecological surgeries.
Materials and Methods: This single-blinded randomised clinical
study conducted at PES Institute of Medical Sciences and
Research, Kuppam, Andhra Pradesh, India, from January 2020
to June 2021. The clinical trial was conducted on 80 patients
belonging to American Society of Anaesthesiologist (ASA) I and
II posted for elective laparoscopic gynaecological surgeries.
Patients were randomly allocated into two groups with 40
patients in each group. Group T (TAP block) received 0.6 mL/kg
of 0.25% bupivacaine for bilateral ultrasound guided TAP block
and group O (port sites local infiltration) received 0.6 mL/kg of
0.25% bupivacaine for port sites infiltration. At the end of surgery,
patients received either TAP block or port site infiltration as per the group allocated and then extubated. Postoperative pain
intensity using Visual Analogue Scale (VAS) score were recorded
at the time of shifting as 0 hr and then every 2 hrs, 4 hrs, 6 hrs, 8
hrs, 12 hrs and 24 hrs. The mean time for first rescue analgesia
and total number of rescue analgesic given in first 24 hrs were
noted. Haemodynamic parameters and side-effects with study
drug were noted. For inferential statistics, numerical data was
analysed by Chi-square test and for categorical data student’s
t-test was used. A p-value <0.05 was considered as statistically
significant.
Results: Demographic parameters in both groups were
comparable. There was no significant difference in VAS score
upto 4 hours in between two groups. But mean VAS score was
significantly low in group T when compared to group O at 6 hours
(2.2±0.4 vs 2.7±0.5), 8 hours (2.7±0.4 vs 3.2±0.7) and 12 hours
(3.3±0.5 vs 3.6±0.5). The time to receive rescue analgesic was
longer in TAP block group (13.7±1.5 vs 10.6±1.64 hrs) when
compared to port sites local infiltration group. And total number
of rescue analgesia received was low in TAP block group (70%
recieved single dose) when compared to port sites local infiltration
group (80% received two doses).
Conclusion: The TAP block and port sites infiltration in patients
undergoing laparoscopic gynaecological surgeries are used for
effective postoperative analgesia as part of multimodal analgesia,
which reduces the use of other analgesics like NSAIDS and
opioids. However, TAP block provides superior and prolonged
pain relief when compared to port sites local infiltration. |
| first_indexed | 2024-04-10T21:52:53Z |
| format | Article |
| id | doaj.art-028eb2c9b97840a9a071d66ba21e9fdb |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T21:52:53Z |
| publishDate | 2022-10-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-028eb2c9b97840a9a071d66ba21e9fdb2023-01-18T10:39:55ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-10-011610UC17UC2110.7860/JCDR/2022/59195.17016Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical TrialMS Anusha0K Udaya Bhaskar1Jaganath2T Dharani Priya3Mohan Koyee4Assistant Professor, Department of Anaesthesiology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.Associate Professor, Department of Anaesthesiology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.Associate Professor, Department of Anaesthesiology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.Postgraduate Student, Department of Anaesthesiology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.Professor and Head, Department of Anaesthesiology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.Introduction: Pain relief postoperatively has advantages related to better patient satisfaction in terms of early ambulation and discharge and also better cardiovascular stability, decreased infections, neurological complications, prevention of thromboembolic phenomenon, and chronic pain syndrome. Non Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are the most commonly used drugs in pain management. Transverse Abdominis Plane (TAP) block is a regional analgesic technique, which provides analgesia of the anterolateral abdominal wall and hence can be used to provide analgesia for caesarean section, hernia repairs, hysterectomies, cholecystectomy. Aim: To compare the effectiveness of bilateral TAP block versus port sites local anaesthetic infiltration to relieve postoperative pain in laparoscopic gynaecological surgeries. Materials and Methods: This single-blinded randomised clinical study conducted at PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India, from January 2020 to June 2021. The clinical trial was conducted on 80 patients belonging to American Society of Anaesthesiologist (ASA) I and II posted for elective laparoscopic gynaecological surgeries. Patients were randomly allocated into two groups with 40 patients in each group. Group T (TAP block) received 0.6 mL/kg of 0.25% bupivacaine for bilateral ultrasound guided TAP block and group O (port sites local infiltration) received 0.6 mL/kg of 0.25% bupivacaine for port sites infiltration. At the end of surgery, patients received either TAP block or port site infiltration as per the group allocated and then extubated. Postoperative pain intensity using Visual Analogue Scale (VAS) score were recorded at the time of shifting as 0 hr and then every 2 hrs, 4 hrs, 6 hrs, 8 hrs, 12 hrs and 24 hrs. The mean time for first rescue analgesia and total number of rescue analgesic given in first 24 hrs were noted. Haemodynamic parameters and side-effects with study drug were noted. For inferential statistics, numerical data was analysed by Chi-square test and for categorical data student’s t-test was used. A p-value <0.05 was considered as statistically significant. Results: Demographic parameters in both groups were comparable. There was no significant difference in VAS score upto 4 hours in between two groups. But mean VAS score was significantly low in group T when compared to group O at 6 hours (2.2±0.4 vs 2.7±0.5), 8 hours (2.7±0.4 vs 3.2±0.7) and 12 hours (3.3±0.5 vs 3.6±0.5). The time to receive rescue analgesic was longer in TAP block group (13.7±1.5 vs 10.6±1.64 hrs) when compared to port sites local infiltration group. And total number of rescue analgesia received was low in TAP block group (70% recieved single dose) when compared to port sites local infiltration group (80% received two doses). Conclusion: The TAP block and port sites infiltration in patients undergoing laparoscopic gynaecological surgeries are used for effective postoperative analgesia as part of multimodal analgesia, which reduces the use of other analgesics like NSAIDS and opioids. However, TAP block provides superior and prolonged pain relief when compared to port sites local infiltration.https://www.jcdr.net/articles/PDF/17016/59195_CE(AnK)_F[SH]_PF1(SC_SS)_PFA(SC_SS)_PN(SS).pdfanalgesiabupivacaineopioidsvisual analogue scale |
| spellingShingle | MS Anusha K Udaya Bhaskar Jaganath T Dharani Priya Mohan Koyee Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial Journal of Clinical and Diagnostic Research analgesia bupivacaine opioids visual analogue scale |
| title | Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial |
| title_full | Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial |
| title_fullStr | Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial |
| title_full_unstemmed | Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial |
| title_short | Postoperative Analgesic Efficacy of Transverse Abdominis Plane Block versus Port Site Local Infiltration in Laparoscopic Gynaecological Surgeries-A Randomised Clinical Trial |
| title_sort | postoperative analgesic efficacy of transverse abdominis plane block versus port site local infiltration in laparoscopic gynaecological surgeries a randomised clinical trial |
| topic | analgesia bupivacaine opioids visual analogue scale |
| url | https://www.jcdr.net/articles/PDF/17016/59195_CE(AnK)_F[SH]_PF1(SC_SS)_PFA(SC_SS)_PN(SS).pdf |
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