Transverses Abdominis Plane Block Versus Trocar Site Infiltration in Gynecologic Laparoscopy An Observational Study

Abstract

Background and Aims: Laparoscopic surgery is nowadays gold standard procedure undertaken for various surgical procedures and people prefer laparoscopic approach but the effective analgesic regimen for such patients has not been devised and anaesthesiologists prefer multimodal regimes. Despite the minimally invasive nature of this procedure, patients experience a considerable amount of pain in the first 24 h postoperatively. In our study, we are comparing the degrees of pain relief with TAP block vs Trocar site infiltration using VAS, the duration of postoperative analgesia achieve by TAP block and compare it with Trocar site infiltration and total consumption of rescue analgesia consumed in first 24 hours postoperatively in patients undergoing gynaecologic Laparoscopic surgeries. Methods: After obtaining approval from the hospital Ethical committee and written informed consent from patients, this observational study was undertaken at the Government Lalla Ded Hospital which is one of the associated hospitals of Government Medical College, Srinagar during routine hours on 100 patients posted for elective Gynecological Laparoscopic surgery under general anesthesia. A total sample size of 100 patients (n= 50) for each group was calculated using PASSE (power and sample estimation) for study design and analysis. Assuming 30% improvement in pain score with error of 0.05 (i.e. 5% of DOF (degree of freedom). Results: Visual analogue scale at different time intervals were statistically significantly lower at all times in Group A than Group B p-value (p<0.05). The time to first request for analgesia was higher in group A as compared to group B with statistical difference among the study groups p-value (p<0.05).
 Conclusion: As a promising novel post-operative pain treatment procedure, TAP block is cost effective and one of the safest, easiest and the most effective supplemental techniques as part of analgesic regimen. It improves pain scores in gynecologic laparoscopy.

Evaluation of the Two-Point Ultrasound-Guided Transversus Abdominis Plane Block for Laparoscopic Canine Ovariectomy

“…In human medicine, the TAP block has been used successfully for pain relief in a wide variety of laparoscopic procedures [ 12 , 13 , 14 , 15 , 16 ]. Although the studies are less widespread in veterinary medicine, single-injection TAP blocks for conventional [ 17 , 18 ] and laparoscopic ovariectomy (LapOV) [ 19 ] in dogs have been recently reported.…”