Yasmeen Afridi, Naheed Fatima, Suresh Kumar, Iqbal Memon, Ishtiaq Anwar.
Comparison of Local Anesthetic Wound Infiltration Versus Transversus Abdominis Plane Block in patients Undergoing Total Abdominal Hysterectomy.
J Surg Pak Jan ;23(2):51-4.

Objective: To compare the analgesic effectiveness of local wound infiltration versus transversus abdomen is plane (TAP) block after total abdominal hysterectomy (TAH). Study design: Experimental study. Place & Duration of study: Department of Anaesthesiology, Pakistan Institute of Medical Sciences (PIMS) Islamabad, from June 2014 to August 2015. Methodology: Sample size of 52 patients was calculated using WHO calculator. Non probability consecutive sampling was used for patients` selection. Ethical approval was taken from ethical review board of PIMS. Patients were randomly divided into two groups using computer generated random number. Group A was given local anaesthetic infiltration with 0.6ml/kg of 0.25% bupivacaine and Group B was given transverse abdominal plane block (TAP) bilaterally with 18G needle piercing cephalic to iliac crest skin for about 2 inches. Data was analysed using SPSS version 22. Student t test was applied and p <0.05 was considered significant. Results: Total of 52 patients were included in the study with 1:1 randomization (26 patients in each group). There were 30 (58%) males and 22 (42%) females. Mean age of patients was 44.4+-7.3 year. Significantly longer T rescue time was noted in TAP block (148+-46.7 minutes) as compared to infiltration (85.3+-38 minutes - p=0.003). Significantly lower mean pain scores were reported in TAP block (4.12+-1.4) as compared infiltration (5.58+-1.98 - p=0.001). Sedation was found better in TAP block as compared to infiltration (p<0.05). Conclusions: TAP block is an effective multimode analgesic in terms of pain reduction, sedation and T rescue after total abdominal hysterectomy. The process is reliable, easy to perform and provide effective analgesia. No complications and side effects were reported with TAP block.

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