title: Randomized trial of transversus abdominis plane block at total laparoscopic hysterectomy: effect of regional analgesia on quality of recovery.
abstract: OBJECTIVE
  The objective of the study was to determine whether transversus abdominis plane (TAP) block improves the early postoperative quality of recovery (QoR-40). The secondary objectives measured postoperative pain, length of stay, and narcotic use.
  
  
  METHODS
  This was a randomized, single-blinded trial of TAP block versus no block on women undergoing laparoscopic hysterectomy. TAP block patients received 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 placed under ultrasound guidance on each side. The outcomes were measured using validated quality of recovery questionnaires (QoR-40), visual analog scales (VAS) for pain, and documented narcotic use in the electronic medical record.
  
  
  RESULTS
  In 58 women, no differences in demographics were noted between groups. Comparisons of pain and recovery between the 2 groups showed no differences. There was no decrease in narcotic use or length of stay among those who received the TAP block.
  
  
  CONCLUSIONS
  TAP block does not improve postoperative QoR-40 scores or VAS pain scores following laparoscopic hysterectomy, nor does it decrease narcotic pain medication use.
authors: Department of Obstetrics and Gynecology, Metrohealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA. skane@metrohealth.org
authors: Sarah M
authors: SM
authors: Kane
authors: Vincent
authors: V
authors: Garcia-Tomas
authors: Marilyn
authors: M
authors: Alejandro-Rodriguez
authors: Brendan
authors: B
authors: Astley
authors: Robert R
authors: RR
authors: Pollard
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging / Q000187:drug effects; D000328:Adult; D000577:Amides / Q000627:therapeutic use; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D020127:Recovery of Function / Q000187:drug effects*; D000077212:Ropivacaine; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine