title: Comparing the effectiveness of ropivacaine 0.5% versus ropivacaine 0.2% for transabdominis plane block in providing postoperative analgesia after appendectomy.
abstract: OBJECTIVE
  The basis for the transversus abdominis plane (TAP) block involves infiltration of a local anesthetic into the neurofascial plane between the internal oblique and the transversus abdominis muscles, causing a regional block that spreads between the L1 and T10 dermatomes. Thus, the TAP block is said to be suitable for lower abdominal surgery. This study was designed to compare the analgesic efficacy of two different concentrations of ropivacaine for TAP block in patients undergoing appendectomy.
  
  
  METHODS
  Fifty-six patients with American Society of Anesthesiologists physical status I or II, aged 18 years and above, undergoing appendectomy were recruited in this prospective, randomized, double-blind study. They were divided into two groups: Group A patients who received 0.5 mL/kg of ropivacaine 0.5% and Group B patients who received 0.5 mL/kg of ropivacaine 0.2% via TAP block under ultrasound guidance. Postoperative pain was assessed using the visual analog scale upon arrival at the recovery room in the operating theatre, just prior to being discharged to the ward, and at 6 hours, 12 hours, 18 hours, and 24 hours postoperatively to compare the effectiveness of analgesia.
  
  
  RESULTS
  Intraoperatively, patients in Group B required a significantly greater amount of additional intravenous fentanyl than those in Group A. There were no significant statistical differences in pain scores at rest and on movement at all assessment times as well as in the dose of 24-hour intravenous morphine consumption given via patient-controlled analgesia postoperatively between the two groups.
  
  
  CONCLUSIONS
  The effectiveness of two different concentrations of ropivacaine (0.5% versus 0.2%) given via TAP block was comparable in providing postoperative analgesia for patients undergoing appendectomy.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Reymi Marseela
authors.initials: RM
authors.lastname: Abdul Jalil
authors.affiliation: Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia. Electronic address: nurlia@ppukm.ukm.edu.my.
authors.forename: Nurlia
authors.initials: N
authors.lastname: Yahya
authors.affiliation: Department of Anaesthesia and Intensive Care, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia.
authors.forename: Omar
authors.initials: O
authors.lastname: Sulaiman
authors.affiliation: Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Wan Rahiza
authors.initials: WR
authors.lastname: Wan Mat
authors.affiliation: Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Rufinah
authors.initials: R
authors.lastname: Teo
authors.affiliation: Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Azarinah
authors.initials: A
authors.lastname: Izaham
authors.affiliation: Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Raha Abdul
authors.initials: RA
authors.lastname: Rahman
mesh_terms: D000005:Abdomen / Q000294:innervation; D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods*; D001062:Appendectomy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000077212:Ropivacaine
keywords: analgesia; anesthetics, local: ropivacaine. appendectomy; nerve block: transversus abdominis plane; pain measurement; pain, postoperative