The efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing total abdominal hysterectomy

Abstract We aimed to investigate the effects of USG guided preoperative and postoperative TAP block on postoperative analgesia using patient controlled analgesia (PCA) in patient undergoing total abdominal hysterectomy. Materials and Methods After obtaining ethical approval, 18-65 age and ASA I-II, 60 patients undergoing to total abdominal hysterectomy were included to this study. Premedication wasn't given to the patients. Following standard monitoring, anesthesia was induced with 1 µg / kg remifentanyl, 2 mg/ kg propofol, 0,1 mg / kg vecuronyum and maintained in a mixture of % 40 N20 and % 60 O2, and % 6-8 desflurane. Randomly-selected 30 patients were allocated to USG guided bilateral TAP blocks after general anesthesia before the surgery (Grup preop), and 30 patients were allocated to postoperative group (Group postop) with same block. All of the patients were extubated after the surgery and taken to postoperative care unit (PACU). After the VAS score of the patients was questioned, VAS ≥ 3 patients were administered the first dose of morphine with PCA device. VAS in resting, VAS in motion, sedation scoring, nausea and vomiting, additional analgesic and antiemetic requirement of the patients in PACU and the postoperative 2.,4.,6.,12. and 24. hours were recorded. Results Pain scores at rest were significantly lower at 2. and 4. hours in postoperative group (p<0.05). Morphine consumption for 24 hours was statistically lower in postoperative group compared to preoperative group (p<0.05). Conclusion We concluded that in total abdominal hysterectomy operations, USG guided post operative TAP block reduces pain scores and morphine consumption for 24 hours more than preoperative TAP block.