The use of ultrasound-guided transversus abdominis plane blocks for total abdominal hysterectomy: a double-blind, controlled trial

Authors

  • Adri Marais University of Cape Town
  • Owen Porrill University of Cape Town
  • M F James University of Cape Town
  • Robert Dyer University of Cape Town

Keywords:

“transversus abdominis plane blocks”, ”TAP blocks”, “ultrasound guided”, “total abdominal hysterectomy”, “morphine comsumption”

Abstract

Objectives: This study investigated the postoperative analgesic efficacy of bilateral ultrasound-guided transversus abdominis plane (TAP) blocks, in patients undergoing total abdominal hysterectomy. Design, setting and subjects: This was a prospective, randomised, double-blind, controlled study. Thirty patients were allocated to two groups; a TAP block group (n = 15) and a placebo group (n = 15). The TAP blocks were performed with 0.25% bupivacaine. The placebo group received sham blocks with normal saline, post induction of anaesthesia. Postoperatively, patients received patient-controlled intravenous morphine for analgesia. Outcome measures: The primary outcome was morphine consumption during the first 24 hours postoperatively. Secondary outcomes were adequacy of pain relief, as assessed by pain scores at 0, 6 and 24 hours postoperatively, and side-effects. Results: Our study showed a significant between-group difference in morphine requirements (5.2 ± 3.9 vs. 9.7 ± 4.3 mg, p = 0.007, and 12.9 ± 8.9 mg vs. 25 ± 12.1 mg, p = 0.006) for the TAP group, compared with the placebo group at six and 24 hours, respectively. There were no significant between-group differences in pain scores. There were no complications with any of the blocks. Conclusion: Bilateral ultrasound-guided TAP blocks significantly reduced postoperative morphine consumption in a multimodal postoperative analgesia regimen for abdominal hysterectomy.

Author Biographies

Adri Marais, University of Cape Town

MBChB Specialist Registrar Department of Anaesthesia University of Cape Town South Africa

Owen Porrill, University of Cape Town

FCA (SA) Consultant Anaesthetist Department of Anaesthesia University of Cape Town South Africa

M F James, University of Cape Town

PhD Emeritus Professor Department of Anaesthesia University of Cape Town South Africa

Robert Dyer, University of Cape Town

PhD (UCT) Professor and Second Chair Department of Anaesthesia University of Cape Town South Africa

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Published

2013-10-14

Issue

Section

Original Research