To Compare 0.25% Ropivacaine And 0.25% Bupivacaine In  Tap Block For Postoperative Analgesia In Patients  Undergoing Abdominal Surgeries.

Vedanshi Himanshu Desai; Jagruti R. Satasia; Khushboo H. Desai; Mitali G Patel; Devyani D Solanki

doi:10.48165/ijabms.2021.233705

Authors

Vedanshi Himanshu Desai MD Anesthesiology, Dept. of anesthesia, Smt. SCL general hospital, Ahmedabad.
Jagruti R. Satasia Associate professor, Dept. of anesthesia, Smt. SCL general hospital, Ahmedabad.
Khushboo H. Desai 2nd year resident, Dept. of anesthesia, Smt. SCL general hospital, Ahmedabad.
Mitali G Patel 1st year resident, Dept. of anesthesia, Smt. SCL general hospital, Ahmedabad.
Devyani D Solanki 1st year resident, Dept. of anesthesia, Smt. SCL general hospital, Ahmedabad.

DOI:

https://doi.org/10.48165/ijabms.2021.233705

Keywords:

Postoperative analgesia, abdominal surgeries, TAP block

Abstract

INTRODUCTION Pain has been defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.¹Pain is the most dreaded problem which a person fears after any surgery. The transversus abdominis plane (TAP) block is an anaesthesia technique that provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall.⁴Since the thoracolumbar nerves originating from the T6 to L1 spinal roots run into this plane and supply sensory nerves to the anterolateral abdominal wall⁵, the local anaesthetic spread in this plane can block the neural afferents and provide analgesia to the anterolateral abdominal wall. AIM AND OBJECTIVES Aim of study was to compare 0.25% Ropivacaine and 0.25% Bupivacaine in TAP block for postoperative analgesia in patients undergoing Abdominal Surgeries. The following parameters were compared: A. To study the effectiveness of transverses abdominis plane block for post-operative analgesia in Abdominal Surgeries. B. To compare the duration of analgesia and its effectiveness conferred by 0.25% Ropivacaine and 0.25% Bupivacaine. C. Total requirement of rescue analgesia. D. To watch for occurrence of side effects, if any MATERIALS AND METHODS A comparative clinical study was carried out on 60 adult patients belonging to ASA grade I or II, scheduled for elective Abdominal Surgeries. All patients were administered spinal anaesthesia with bupivacaine heavy 0.5%, 2.0-4.0 ml with 25 G spinal needle at L2-L3 or L3-L4 vertebral interspace. The patients were randomly allocated in two groups and study drug was injected at the end of surgery according to the group. The volume of administered drug kept constant (20 ml). Group I: Patients received TAP BLOCK on each side with 10ml 0.25% Ropivacaine. Group II: Patients received TAP BLOCK on each side with 10ml 0.25% Bupivacaine. CONCLUSION Transversus Abdominis Plane Block (TAP Block) provides better postoperative analgesia in various abdominal surgeries. 0.25% ropivacaine and 0.25% bupivacaine are equally effective in TAP block and provides effective postoperative analgesia but ropivacaine group shown longer duration of action compared to bupivacaine which was statistically significant without causing any increased adverse effects.

References

International association for the study of pain, Subcommittee on Taxonomy: Pain terms: a list with definitions and notes on usage. Pain 1979; 6: 249-52.

Aasvang E, Kehlet H. Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 2005;95(1):69–76.

D. N. Onwochei, J. Borglum and A. Pawa “Abdominal wall blocks for intra-abdominal surgery” BJA Education, 18(10): 317-322, 2018.

E. Brogi, R. Kazan, S. Cyr, F. Giunta, and T. M. Hemmer ling, “Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomizedcontrolled trials,” Canadian Journal of Anesthesia, 2016;63(10):1184–1196

W. M. Rozen, T. M. N. Tran, M. W. Ashton, M. J. Barrington, J. J. Ivanusic, and G. I. Taylor, “Refining the course of the thoracolumbar nerves: a new understanding of the innervation of the anterior abdominal wall,” Clinical Anatomy, 2008; 21(4): 325–333

A. N. Rafi, “Abdominal field block: a new approach via the lumbar triangle,” Anaesthesia,2001;56(10): 1024–6

J. G. McDonnell, B. O’Donnell, G. Curley, A. Heffernan, C. Power, and J. G. Laffey, “The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial,” Anesthesia and Analgesia, 2007; 104(1): 1937

P. Hebbard, Y. Fujiwara, Y. Shibata, and C. Royse, “Ultrasound-guided transversus abdominis plane (TAP) block,” Anaesthesia and Intensive Care, 2007; 35(4); 616–617

P. Hebbard, “Subcostal transversus abdominis plane block under ultrasound guidance,” Anesthesia and Analgesia, 2008; 106(2): 674-675

J. Borglum, C. Maschmann, B. Belhage, and K. Jensen, “Ultrasound guided bilateral dual transversus abdominis plane block: a new four-point approach, “Acta Anaesthesiologica Scandinavica, 2011; 55(6): 658-63

W. Mei, C. Jin, L. Feng et al., “Case report: bilat-eral ultrasound-guided transversus abdominis plane block combined with ilioinguinaliliohypogastric nerve block for cesarean delivery anesthesia,” Anesthesia and Analgesia, 2011;113(1): 134–137

M. Singh, K. J. Chin, and V. Chan, “Ultrasound-guided transversus abdominis plane (TAP) block: a useful adjunct in the management of postoperative respiratory failure,” Journal of Clinical Anesthesia, 2011; 23(4): 303-306

Almarakbi WA, Kaki AM. Dexmedetomidine plus bupivacaine in TAP block. Saudi J Anaesth.2014;8:161–6.

Uma Srivastava, Shilpi Verma et al “Efficacy of trans abdominis plane block for post caesarean delivery analgesia: A double blind, randomized trial” Saudi Journal of Anaesthesia 2015; 9(3): 298-302.