Original Research Article
Year: 2020 | Month: June | Volume: 10 | Issue: 6 | Pages: 1-11
Comparative Study of Ultrasound Guided TAP Block and Epidural Analgesia for Postoperative Analgesia in Patients Undergoing Lower Abdominal Surgeries
Kaetiki Manhas1, C.S. Ahluwalia2, Shaleen Trivedi3
1P.G. Student, 2Senior Consultant & Professor, 3Assistant Professor,
Deptt. of Anaesthesiology and Critical Care, Command Hospital (WC), Chandimandir, Panchkula,
Haryana- 134107
Corresponding Author: Kaetiki Manhas
ABSTRACT
Background: TAP Block, recently has been given under ultrasound guidance with promises of better localization and deposition of the local anaesthetic with improved accuracy. Every year millions surgeries performed worldwide varying between minor to major, short to long duration on different patients and on different organs. No matter the type, time and procedure of surgery, one thing common to all surgeries is postoperative pain.
Aims and Objectives: To compare the efficacy and outcomes of ultrasound guided tap block and epidural analgesia for postoperative analgesia in patients of lower abdominal surgeries.
Material and Methods: This prospective randomised study included 80 patients with ASA status I & II aged between 20 and 65 years who underwent lower abdominal surgeries and further sub-divided into two groups, group E (n=40) and group T (n=40). Patients in group E were given epidural analgesia and patients in group T were given ultrasound guided bilateral TAP block.
Results: Pain distribution was found significant at 2 hours, 6 hours, 8 hours and 10 hours. After the 12 hour time period onwards, the pain score distribution was mild in both groups. Pain score distribution score on coughing among epidural and TAP block groups was found significant at 2 hours, 10 hours and 12 hours. Paracetamol as well as tramadol consumption was higher in TAP block group. Incidence of post-operative nausea and vomiting was seen among both groups. Heart rate was higher in the epidural group as compared to TAP block group. Mean SpO2 was significantly higher in epidural group at baseline and immediate postoperative reading. Mean SBP as well as DBP were significantly higher in the Epidural group at baseline reading whereas at 5 minutes, 15 minutes, 45 minutes, 2 hours and 4 hour reading, TAP block group had significantly higher SBP as compared to Epidural group.
Conclusion: Study concluded that ultrasound guided transversus abdominis plane block is as effective method as epidural anesthesia in providing analgesia in patients undergoing lower abdominal surgery. In terms of patient discomfort, the results differ wherein the pain at rest as well as coughing was found to be higher in TAP block. Nausea vomiting starts late in TAP block but once started it stays for longer duration.
Key words: USG TAP block, Epidural analgesia, Postoperative analgesia, Lower abdominal surgery