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Ultrasound-guided posterior transversus abdominis plane block versus epidural analgesia for postoperative pain relief in lower abdominal surgeries
Arnab Das1, Kunal Tiwari2, Sanjay Kumar Sharma3, Shalendra Singh4, Subhasish Patnaik4, Nimish Gaur5
1 Department of Anaesthesiology and Critical Care, Inhs Kalyani, Visakhapatnam, Andhra Pradesh, India
2 Department of Anaesthesiology and Critical Care, Command Hospital (SC), Jodhpur, Rajasthan, India
3 Department of Obstetric and Gynaecology, Armed Forces Medical College, Jodhpur, Rajasthan, India
4 Department of Anaesthesiology and Critical Care, Armed forces Medical College, Pune, Maharashtra, India
5 Department of Anaesthesiology, MH, Jodhpur, Rajasthan, India
Correspondence Address:
Shalendra Singh,
Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune - 411 040, Maharashtra
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/jmedsci.jmedsci_11_22
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Background: Among the regional anesthesia techniques used for postoperative analgesia for lower abdominal surgeries, epidural analgesia (EA) has been the gold standard and time-tested technique, but complications and contraindications for the same warrant the need for other equally good analgesic techniques. Aim: The present study compared posterior transversus abdominis plane (TAP) block to EA for postoperative analgesic efficacy in patients undergoing lower abdominal surgeries. Methods: Prospective, observational study in patients undergoing lower abdominal surgeries under general anesthesia. Patients received ultrasound-guided (USG) 20 ml 0.2% ropivacaine each side in TAP block (Group A, n = 50) or 10 ml of 0.2% ropivacaine was administered in epidural (Group B; n = 50) before extubation. The Visual analog scale (VAS) score, hemodynamic parameters, and ill effects were recorded. Results: The blood pressure was significantly lower in first 6 h of block in Group B. VAS score was significantly lower in Group A in first 6 h of surgery. It was observed that a significantly higher number of patients in the Group B required rescue analgesic and at higher dosages. Postoperative nausea and vomiting were found in 32% of Group B and 22% of Group A patients. Conclusion: TAP block has almost no complications, keeps the patient more hemodynamically stable, and offers a better early postoperative analgesia when compared to EA in patients undergoing lower abdominal surgeries.
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