Pre-emptive ultrasound-guided transversus abdominis plane block in open appendicectomy

Abstract

Background Transversus abdominis plane (TAP) block is a newly effective peripheral block which involving mainly the nerves of the anterior abdominal wall in lower abdominal surgery. The present study aimed to evaluate the postoperative analgesic efficacy of right-sided ultrasound guided TAP block by using 20 millimeters of bupivacaine 0.25% in patients undergoing open appendicectomy. Patients and methods After taking informed consent, fifty patients (ASA I and II) undergoing open appendicectomy were randomized into 2 groups (25 each). After induction of general anesthesia; Group B received right side ultrasound guided TAP block using 20 ml bupivacaine 0.25%. Group S (standard group) received general anesthesia without TAP block. Postoperative analgesia by ketorolac and paracetamol was given as required. Postoperative VAS at rest and movement, intra and post operative hemodynamics, analgesic requirements and their side effects were recorded for 24 hours. Results A significant reduction of VAS up to twelve hours postoperatively detected in the TAP block group with bupivacaine 0.25%. There was also significant elongation of time to the first analgesia, significant reduction in number of rescue analgesics, as will as there were significant decrease in nausea, vomiting and pruritus between two groups. Conclusion Right-sided ultrasound guided TAP block using 20 ml of bupivacaine 0.25% had effective postoperative analgesia for twelve hours after the open appendicectomy.