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. 2018 Jun;62(6):449-454.
doi: 10.4103/ija.IJA_221_18.

Post-operative bilateral continuous ultrasound-guided transversus abdominis plane block versus continuous local anaesthetic wound infusion in patients undergoing abdominoplasty

Eman Ramadan Salama  1
Affiliations

Post-operative bilateral continuous ultrasound-guided transversus abdominis plane block versus continuous local anaesthetic wound infusion in patients undergoing abdominoplasty

Eman Ramadan Salama. Indian J Anaesth. 2018 Jun.

Abstract

Background and aims: Transversus abdominis plane (TAP) block and continuous local anaesthetic wound infusion are used as part of multimodal analgesia to treat postoperative pain after lower abdominal surgeries. The aim of this randomised controlled study was to assess the efficacy of the two techniques and compare the two in patients undergoing abdominoplasty.

Methods: Ninety female patients undergoing abdominoplasty were allocated to receive continuous wound infusion with saline (control group, GC, n = 30), continuous bilateral TAP block with 0.25% levobupivacaine (group GT, n = 30), or continuous wound infusion with 0.25% levobupivacaine (group GW, n = 30). The primary end-point was morphine requirement in the first 48 h. Numerical rating scale (NRS) at rest and during movement, time to first morphine dose and time to first ambulation were recorded.

Results: Morphine requirement in the first 48 h was significantly higher in GC than GW and GT (61.9 ± 12.8, 21.5 ± 9.5, and 18.9 ± 8.1 mg, respectively; P = 0.001), but GW and GT were comparable (P = 0.259). NRS was significantly higher in GC during movement in the first 24 h. GW and GT showed significantly longer time to first morphine dose (6.5 ± 1.7 and 8.9 ± 1.4 h, respectively, vs. 1.2 ± 0.3 h in GC) and significantly shorter time to first ambulation (7.8 ± 3.1 and 6.9 ± 3.4 h, respectively, vs. 13.2 ± 4.9 h in GC) (P = 0.001).

Conclusion: Continuous bilateral ultrasound-guided TAP block and continuous local anaesthetic wound infusion significantly decreased total morphine consumption in the first 48 h compared to placebo; however, both treatment techniques were comparable.

Keywords: Abdominoplasty; analgesia; local anaesthetic; postoperative pain; transversus abdominis plane block.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Numerical Rating Scale pain scores at rest. NRS, Numerical Rating Scale; GC, control group; GW, continuous wound infusion group; GT, TAP block group; H1, 1 h after arrival to PACU; H3, 3 h postoperative; H6, 6 h postoperative; H12, 12 h postoperative; H24, 24 h postoperative; H36, 36 h postoperative; H48, 48 h postoperative
Figure 2
Figure 2
Numerical Rating Scale pain scores on movement. *Means significant; NRS, Numerical Rating Scale; GC, control group; GW, continuous wound infusion group; GT, TAP block group; H1, 1 h after arrival to PACU; H3, 3 h postoperative; H6, 6 h postoperative; H12, 12 h postoperative; H24, 24 h postoperative; H36, 36 h postoperative; H48, 48 h postoperative
See this image and copyright information in PMC

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