Single Versus Continuous TAP blockage Technique for Management of Postoperative Hysterectomy Pain

Abstract

Nancy Mohamed Ali Rund, Mahmoud Fathy Hassan, Mohammed A Taha Al Afifi, Mohammed El Sayed Abdel Hameed

Background: Transversus abdominis plane blockage technique is performed by administration of local anesthetic agent between the abdominal muscle anatomical planes to block the somatic nervous innervation. Value of continuously infused local anesthetic agents via indwelling catheters in TAP blockage is an area of growing research interest.

Aim: To compare the analgesic efficacy of single shot versus continuous transversus abdomin is plane (TAP) block in cases undergoing total abdominal hysterectomy.

Methodology: All research study subjects enrolled had provided a written informed consent. The research study involved 60 cases having ASA scoring status 1 to 2(according to American society of Anesthesiologist scoring system), aged 35 to 60 years and scheduled to undergo total abdominal hysterectomy cases. All patients were categorized into two research groups in a random manner; single shot TAP research group (n=30 cases) and continuous TAP research group (n=30 cases).

Results: VAS scoring (Visual Analog Scale for Pain) was statistically significantly lower among continuous TAP block research group in comparison to single shot TAP block research group at different time intervals,baseline,1 hour,12 hours 24 hours,36 hours 48 hours 60 hours (p values =0.000, 0.001, 0.001, 0.002, 0.026 consecutively).

Conclusion and Recommendations: TAP blockage prolong the analgesic duration, reduces the VAS scoring particularly in continuous approach more than single shot postoperatively and reduces the requirements for Opioid consumption overall.

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