Vol. 1, Issue 5, Part E (2015)

Background and Objective: Patients having a total abdominal hysterectomy (TAH) must have effective pain management following the procedure. One localized anesthetic treatment that has shown promise in reducing opioid usage and improving pain management is the Transversus Abdominis Plane (TAP) block. In order to determine if TAP block is effective in reducing postoperative pain in patients having TAH, this study set out to do just that.

Material and Methods: This prospective study involved 50 female patients aged 35 to 60 years, slated for elective complete abdominal hysterectomy under spinal anesthesia. This study was conducted at the department of General Surgery, Madha Medical College, Kovur, Chennai, Tamil Nadu, India from April 2014 to March 2015. Patients were randomly assigned to two groups (n=25 each): Group A had a bilateral TAP block with 20 ml of 0.25% bupivacaine postoperatively, while Group B received normal systemic analgesia without a TAP block. Post-operative pain was evaluated with the Visual Analog Scale (VAS) at 1, 2, 4, 6, 12, and 24 hours. The total opioid use within the initial 24 hours and the occurrence of side effects were documented.

Results: At all time intervals, patients in Group A displayed noticeably lower VAS values when contrasted with Group B (p<0.05). Group B had mean VAS scores of 4.6±0.7 at 1 hour, while Group A had 2.1±0.4. The overall amount of opioids taken by Group A was much lower (mean 35.2±5.4 mg) than by Group B (mean 72.6±6.2 mg) (p<0.001). Patients in the TAP block group were less likely to have vomiting and nausea.

Conclusion: When it comes to post-operative pain relief after a total abdominal hysterectomy, TAP block is a safe and effective option. It improves patient comfort and recovery by drastically lowering pain scores and narcotic usage.