oa Southern African Journal of Anaesthesia and Analgesia - The use of ultrasound-guided transversus abdominis plane blocks for total abdominal hysterectomy : a double-blind, controlled trial : original research



This study investigated the postoperative analgesic efficacy of bilateral ultrasound-guided transversus abdominis plane (TAP) blocks, in patients undergoing total abdominal hysterectomy.

This was a prospective, randomised, double-blind, controlled study. Thirty patients were allocated to two groups; a TAP block group (n = 15) and a placebo group (n = 15). The TAP blocks were performed with 0.25% bupivacaine. The placebo group received sham blocks with normal saline, post induction of anaesthesia. Postoperatively, patients received patient-controlled intravenous morphine for analgesia.
The primary outcome was morphine consumption during the first 24 hours postoperatively. Secondary outcomes were adequacy of pain relief, as assessed by pain scores at 0, 6 and 24 hours postoperatively, and side-effects.
Our study showed a significant between-group difference in morphine requirements (5.2 ± 3.9 vs. 9.7 ± 4.3 mg, p = 0.007, and 12.9 ± 8.9 mg vs. 25 ± 12.1 mg, p = 0.006) for the TAP group, compared with the placebo group at six and 24 hours, respectively. There were no significant between-group differences in pain scores. There were no complications with any of the blocks.
Bilateral ultrasound-guided TAP blocks significantly reduced postoperative morphine consumption in a multimodal postoperative analgesia regimen for abdominal hysterectomy.


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