Naslov
The effect of ultrasound-guided transversus abdominis plane block on postoperative analgesia in patients undergoing open primary inguinal hernioplasty under unilateral spinal anaesthesia

Autori
Krobot, Renata ; Lukić, Anita ; Premužić, Jadranka ; Pavličević, Draženka ; Kunštek Božić, Vlatka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Euroanaesthesia 2015 : abstracts ; u: European Journal of Anaesthesiology 32 (2015) S53 ; Echo-Guided locoregional Blocks, 15AP1-5 / - , 2015, 410-410

Skup
Euroanaesthesia 2015

Mjesto i datum
Berlin, Njemačka, 30.05.2015. - 02.06.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
transversus abdominis plane block; postoperative analgesia; inguinal hernioplasty; unilateral spinal anaesthesia

Sažetak
Background and Goal of Study: Transversus abdomins plane (TAP) block has an increasing role in analgesia after lower abdominal surgery. In this study we evaluated postoperative analgesic efficacy of ultrasound-guided TAP block in patients undergoing open primary inguinal hernioplasty under unilateral spinal anaesthesia. Materials and Methods: After obtaining hospital ethical committee approval and informed patient consent, 40 ASA I-III patients aged 26-83 scheduled for open inguinal hernioplasty were randomly allocated to 2 groups, no-TAP (n=20) and TAP (n=20) group. After premedication (midazolam, 7.5 mg p.o.) all patients intrathecally received sufentanil 2.5 µg and 0.5% hyperbaric bupivacaine 7.5 mg at L3-L4 intervertebral space over 60 s, in lateral decubitus position with operative side down maintained for 10 min before returning to supine position. After surgery, patients in TAP group received ultrasound guided TAP block with 30 ml of 0.375% bupivacaine. Diclofenac 75 mg iv was initiated on patient’s request and was administered at 12-hour interval. In case of inadequate analgesia (VAS > 3), paracetamol 1 g iv at 6-hour interval was given. At any time, if pain relief was still inadequate, tramadol 100 mg iv was administered. Visual analogue pain scores (VAS 0-10 scale) at 4, 8, 12 and 24 h postoperatively, time to first analgesic, maximum VAS score, tramadol administration during 24-hour period and side effects were analized. Results and Discussion: Demographic data and hernioplasty duration did not differ between the groups. Median (25th and 75th interquartile range) VAS scores (no-TAP vs TAP) were different at all time points, VAS 4 h: 5 (3, 5) vs 2 (1, 4), P< 0.001 ; VAS 8 h: 4 (3, 5) vs 3 (2, 4), P= 0.002, VAS 12 h: 4 (3, 4) vs 2 (2, 3), P<0.001 ; VAS 24 h: 3 (2, 4) vs 2 (1, 2), P< 0.001. Maximum VAS score during the 24-hour period was 5 (5, 6) in no-TAP and 4 (3, 4) in TAP group, P<0.001. Two (10%) patients in TAP group required no analgesic within 24 h. Time to first analgesic (mean ± SD) was 302 ± 83 min in no-TAP and 399 ± 122 min in TAP group, P = 0.006. Tramadol 100 mg iv received 6 (30%) no-TAP and 4 (20%) TAP group patients, P = 0.720. No side effects in both groups were recorded. Conclusion(s): Ultrasound-guided TAP block significantly reduced postoperative pain during the first 24 h after surgery in patients undergoing open primary inguinal hernioplasty under unilateral spinal anaesthesia.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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