Observational study on the accuracy and speed of ultrasound guided transversus abdominis plane block with two different monitor positions

Abstract

Aim of the study is to analyse the accuracy and speed of ultrasound guided transversus abdominis plane block with two different monitor positions. Prospective observational study was conducted after institutional hospital ethics committee. Twenty four male patients posted for open inguinal hernia repair posted under spinal anaesthesia were selected and divided randomly into two groups and at the end of surgery USG TAP block was given. Group I – USG monitor was kept in line, whereas in Group II – USG monitor was kept in perpendicular to the participant. Twelve anaesthetists who had performed more than 20 procedure were selected and they performed one procedure in each group. History of back pain and neck pain was elicited and any discomfort during procedure was recorded. Accuracy of USG image was recorded. Time taken for the procedure was recorded for both groups. Twelve anaesthetists were selected for this prospective study. Time taken to perform USG TAP in Group I vs Group II was (69.08 ± 8.19 s vs 80.16 ± 4.84s). Difference was statistically significant (p<0.001). Needle placement was significantly more accurate when anaesthetists had the monitor in front of them than to the side (Score was 15 vs 24). Out of 12 anaesthetists, 4 had history of neck pain previously and one was taking treatment for the same. When performed in Group I they had no discomfort but when performed in Group II, anaesthetists with positive history had discomfort during the procedure. It was concluded that the performance of USG TAP block was comfortable and more accurate and the procedure time was shorter, if the monitor was kept in line of the sight of the operator.