Comparison of different concentrations of bupivacain at transversus abdominis plane block with ultrasonography under spinal anesthesia for lower abdominal surgery: Randomised, double blinded, controlled study

Aim of Stduy: The study aimed to find the lowest dose of the most effective bupivacaine used in different concentrations in the transversus abdominis plan (TAP) block accompanied by ultrasonography. Process: Patients who were planned for lower abdominal surgery were informed about the anesthesia methods and the study to be applied in one day before from operations and patients' written and verbal approvals were taken. After being taken to the operation room, the patients were monitored on a standard basis. All phenomenon were treated with 3 ml of 0.5% hyperbaric bupivacaine followed by spinal anesthesia and TAP block accompanied by ultrasonography. Four groups (group A, group B, group C, group D) were randomly assigned by medical doctor other than the anesthetist who performed the peripheral block and spinal anesthesia procedures. 0,125% for Group A, 0,250% for Group B, 0,375% for Group C and 0,5% for Group D were prepared,respectively.TAP black was made accompanied by ultrasonography. Vital findings of the groups, VAS scores, patient satisfaction scales, Ramsey sedation scales, motor and sensory block times were recorded at pre-determined intervals. 50 mg tramadol and 10 mg / kg paracetamol IV bolus were administered in accordance with conventional therapy, when the VAS score exceeded 3. Diagnosis: All of the groups included in the study, there were no differences in terms of first analgesic requirement.demographic data, ASA risk stratification, site and time of operation, patient satisfaction, sedation levels. SAB, DAB and OAB values were lower in Group D than the other groups. The VAS scores of the phenomenon and the additional analgesic requirement were significantly lower in Group D compared to the other groups. Conclusion: We conclude that TAP blotted 0,5% bupivacaine administration in US warts in lower abdominal surgery provides the most effective analgesia and it does not affect the hemodynamics even if it causes decrease in blood pressure.