Postoperative Analgesic Efficacy of Bilateral Transversus Abdominis Plane Block in Patients Undergoing Midline Colorectal Surgeries Using Ropivacaine: A Randomized, Double-blind, Placebo-controlled Trial

Nahida Qazi, Wasim Mohammad Bhat, Malik Zaffar Iqbal, Anisur Rehman Wani, Showkat A Gurcoo, Sahir Rasool, Nahida Qazi, Wasim Mohammad Bhat, Malik Zaffar Iqbal, Anisur Rehman Wani, Showkat A Gurcoo, Sahir Rasool

Abstract

Background: Ultrasound-guided transversus abdominis plane (TAP) block is done as a part of multimodal analgesia for pain relief after abdominal surgeries. This prospective randomized, double-blind, placebo-controlled trial was conducted to evaluate the postoperative analgesic efficacy of bilateral TAP block in patients undergoing midline colorectal surgeries using ropivacaine.

Materials and methods: Eighty patients scheduled for elective colorectal surgeries involving midline abdominal wall incision under general anesthesia were enrolled in this prospective randomized controlled trial. Group A received TAP block with 20 ml of 0.2% ropivacaine on either side of the abdominal wall, and Group B received 20 ml of normal saline. The time to request for rescue analgesia, total analgesic consumption in 24 h, and satisfaction with the anesthetic technique were assessed.

Results: The mean visual analog scale scores at rest and on coughing were higher in control group (P > 0.05). Time (min) to request for the first rescue analgesia was prolonged in study group compared to control group (P < 0.001). The total tramadol consumption in 24 h postoperatively was significantly high in control group (P < 0.001). Nausea/vomiting was more common in control group (P > 0.05). The level of satisfaction concerning postoperative pain control/anesthetic technique was higher in study group (P < 0.001).

Conclusion: TAP block produces effective and prolonged postoperative analgesia in patients undergoing midline colorectal surgery. It is a technically simple block to perform with a high margin of safety. It produces a considerable reduction in mean intravenous postoperative tramadol requirements, reduction in postoperative pain scores, and increased time to first request for further analgesia, both at rest and on movement.

Keywords: Analgesic requirement; colorectal surgeries; ropivacaine; transversus abdominis plane block.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of pain score at rest (visual analog scale; VASREST) between the two groups
Figure 2
Figure 2
Comparison of pain score on coughing (visual analog scale; VASCOUGHING) between the two groups
Figure 3
Figure 3
Comparison of time to first request of tramadol
Figure 4
Figure 4
Comparison of tramadol requirement (mg) in 24 h
Figure 5
Figure 5
Comparison of level of patient satisfaction concerning postoperative pain relief/anesthetic technique between the two groups

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