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Ultrasound Guided Transversus Abdominis Plane Block for Post Operative Analgesia in Patient Undergoing Open Appendicectomy: A Randomized Controlled Study

Namita Gupta, Assistant Professor, Department of Anesthesia, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan 302022, India. , Namita Gupta1 , Udita Anand2 , Avnish K. Bharadwaj3 , Durga Jethava4

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Indian Journal of Anesthesia and Analgesia 4(4):p 1192-1198, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.45

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Abstract

Background: Analgesia is an important concern in the post operative period in terms of complications like delayed mobility, respiratory distress and thromboembolic events. There have been a number of approaches for post operative analgesia in open appendectomy surgeries like Patient Controlled Analgesia (PCA), narcotics, NSAIDS, blocks, etc with certain limitations of each. Amongst these entire methods transversus abdominis plane (TAP) block is recently highlighted in terms of reduction in verbal numerical rating scale (VNRS) and opioids consumption. Aims: Verbal numerical rating scale (VNRS) at resting and VNRS at coughing, total opioids consumption, post operative time at which first rescue analgesia needed. Setting and Design: It is a randomized double blind controlled study. Sixty [60] adult patients included in this study of ASA grade I/II undergoing open appendectomy under general anaesthesia. Methods and Material: Patients were allocated in two groups of, TAP block group and control group. Each group has 30 patients. Patients received TAP block under USG guidance with inj. Levobupivacaine 0.5% 20ml, while Control group patients received standard care. Statistical Design: Statistical analysis was performed with the SPSS software, Trial version 23 for Windows statistical software package (SPSS inc., Chicago, USA) and Primer. Result: In our study we found that the requirement for first rescue analgesia was prolonged in TAP group 312 min v/s 76.80 min in control group, with highly significant p value (pï‚£0.001). Total tramadol doses requirement in twenty four hour in number was also reduced in TAP group which was 2.88±0.726 but 4.48±0, 51 in control group and VNRS score of patients receiving TAP block was less than patients of control group. Conclusion: Ultrasound guided TAP blocks with 20ml 0.5% levobupivacaine is superior in providing post operative analgesia than the control group.


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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.45

Keywords

Postoperative Pain; Ultrasound; Analgesia; Anaesthetic Technique; Regional. 

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