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The Efficacy of Fentanyl as Adjuvant in Ultrasound Guided Oblique Subcostal Transversus Abdominis Plane Block

Swati Bisht* , Swati Bisht* , Natesh S. Rao** , Sadanand Gopal***

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Indian Journal of Anesthesia and Analgesia 4(1):p 101-105, January - March 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4117.16

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Abstract

 Background: Ultrasound guided oblique subcostal transversus abdominis plane block is associated with a wider area of spread (T7­L1). The aim of this study was to assess the efficacy of adding fentanyl to 0.25%bupivacaine in bilateral oblique subcostal transversus abdominis plane block preemptively in patients undergoing laproscopic cystectomy. Method: 100 patients posted for laproscopic ovarian cystectomy were randomly allocated in two equal groups. Group BF received preoperatively 20 ml of 0.25%bupivacaine and 1 mcg fentanyl(1ml) on each side oblique subcostal block and group B received 20 ml bupivacaine with 1ml normal saline. We assessed opioid requirement, the time of first demand of rescue analgesia and twenty four hour morphine requirement. Results: There is a statistically significant difference in the intraoperative fentanyl requirement between the two groups. Group BF required 16.4016.26mcg of intraoperative fentanyl while Group B required 59.8019.05mcg fentanyl (p<0.001). There is a significant difference in the mean VAS score in the two groups. The time of first demand of rescue analgesia was earlier in Group B; 5.961.09hrs compared to 11.182.28 hrs in Group BF (p<0.001). The total 24 hour morphine requirement in Group BF was significantly lower 0.581.01mg compared to Group B i.e. 4.621.63mg (p<0.001). Conclusion: 1mcg/kg fentanyl used as a supplement in bilateral TAP block reduced the need for systemic opioid intra and post operatively and prolonged analgesia in laproscopic ovarian cystectomy patients.

Keywords: Fentanyl; Bupivacaine; Ultrasound Guided Transversus Abdominis Plane Block; Laproscopic Surgeries.

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DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4117.16

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