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

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.

Keywords

• local anesthesia
• nausea and vomiting
• postoperative pain