COMPARISON BETWEEN THE ANALGESIC EFFICACY OF ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK AND DIRECT INFILTRATION OF BUPIVACAINE INTO THE SURGICAL INCISION IN LOWER ABDOMINAL GYNECOLOGICAL SURGERIES

Abstract

Objective: To evaluate and compare the analgesic effectiveness of ultrasound-guided transversus abdominis plane (TAP) block against the direct infiltration of bupivacaine in lower abdominal gynecological surgeries.

Study Design: A randomized controlled trial

Place and Duration of Study: Department of Anesthesia, Jinnah Hospital, Lahore, for six months from 1-08-2024 till 31-01-2025.

Methodology: A total of 60 female patients aged 20–60 years, ASA I–III, and scheduled for lower abdominal gynecological surgery under general anesthesia, were randomly divided into two equal groups. The outcomes assessed were time to first rescue analgesia, 24-hour pain scores (VAS), and 24-hour opioid consumption, done postoperatively. As a result of non-normal data distribution, non-parametric tests were used, and p ≤ 0.05 was taken as statistically significant in SPSS version 27.0.

Results: The TAP block extended the time to first rescue analgesia significantly (median 367.0 min [IQR 36.75]) as compared to the infiltration group (250.5 min [IQR 46.50]) (p < 0.001). The pain scores after 24 hours were less in the TAP group (median 3.0 [IQR 1.00]) than in the infiltration group (5.9 [IQR 1.15]) (p < 0.001). Opioid consumption in the first 24 hours was significantly less in the TAP group (94.5 mg [IQR 26.50]) than in the infiltration group (198.0 mg [IQR 26.25]) (p < 0.001).

Conclusion: The TAP block showed analgesic effects that were significantly better than infiltration as indicated by the much longer time to first rescue analgesia, lower pain scores after 24 hours, and less opioid intake (all p < 0.001).