The Efficacy of Transversus Abdominis Plane Block in Laparoscopic Tubal Sterilisation Surgeries: A Randomised Control Study
Satish Kumar M.N.1, Anu Ludhia K.2, Shreyavathi R., Raghavendra Rao R.S., Surekha C.
1Assistant Professor, 3Professor 4Professor and Head 5Assistant Professor, Department of Anaesthesiolgy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India. 2Registrar, Department of Anaesthesiology, Little flower Hospital and Research Centre, Angamaly, Ernakulam, Kerala 683572, India
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Background: Transversus abdominis plane block is a safe, simple and effective technique, widely used to provide postoperative analgesia for various abdominal surgeries. We evaluated the efficacy of Transversus abdominis plane block in laparoscopic tubal sterilisation surgeries in providing intraoperative and postoperative pain relief. Materials and Methods: 40 ASA I and II adult female patients undergoing laparoscopic sterilisation surgeries were randomised into two groups. Group T (n=20) received TAP block with 20 ml of 0.375% Ropivacaine and Group C (n=20) received general anaesthesia with local infiltration with 10 ml of 0.375% Ropivacaine. Intraoperatively, hemodynamic parameters, Pulse oximetry, end tidal Carbon dioxide concentration and total Propofol requirement were noted. Postoperatively, the recovery profile (Modified Aldrete Score) and Visual analog scale scores were noted at emergence and at 1st, 2nd, 6th, 12th and 24 hours. Results: Patients who underwent surgery under TAP block had a longer time to request for rescue analgesic (Group T 313±77.61 minutes; Group C 34.77±6.72; p<0.001) with a reduced VAS
at Trescue (Group T=4.00±0.00; Group C=4.32±0.89; p<0.001).The mean VAS scores of the patients in Group T were lower when compared to Group C at all time intervals. The Propofol requirement was lower in Group T (Group T =18.88±17.85 mg and Group C =119.54±9.5 p<0.001) and recovery profile better in patients in Group T. Incidence of postoperative nausea and vomiting was the same in both groups. Conclusion: TAP block with sedation can be considered as a suitable alternative to general anaesthesia with local infiltration in laparoscopic sterilisation surgeries.
Corresponding Author : Anu Ludhia K., Registrar, Department of Anaesthesiology, Little flower Hospital and Research Centre, Angamaly, Ernakulam, Kerala 683572, India