title: Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled trial following the CONSORT criteria.
  
  
  METHODS
  Hvidovre University Hospital.
  
  
  METHODS
  Forty-six women scheduled for total abdominal hysterectomy.
  
  
  METHODS
  Women received either ropivacaine 0.75%, 20 mL (n = 24) or 0.9% saline, 20 mL (n = 24) in the transversus abdominis plane on each side.
  
  
  METHODS
  Primary outcome was the 24-h postoperative morphine consumption. Secondary outcomes were pain scores at rest and during coughing, postoperative nausea and vomiting at 1, 2, 4, 6, 8, and 24 h, and time to first mobilization.
  
  
  RESULTS
  There was no difference in the mean 24-h postoperative morphine consumption between the two groups (p = 0.733). The ropivacaine group had significantly lower median pain scores at 1 h (p = 0.008) and 2 h (p = 0.027) postoperatively at rest and at 8 h (p = 0.028) during coughing. There was no significant difference in other secondary outcomes.
  
  
  CONCLUSIONS
  There was no reduction in 24-h morphine consumption when using an ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period.
authors.affiliation: Department of Anesthesia, Hvidovre University Hospital, Hvidovre, Denmark.
authors.forename: Jesper O
authors.initials: JO
authors.lastname: Røjskjaer
authors.forename: Erik
authors.initials: E
authors.lastname: Gade
authors.forename: Louise B
authors.initials: LB
authors.lastname: Kiel
authors.forename: Morten N
authors.initials: MN
authors.lastname: Lind
authors.forename: Lars M
authors.initials: LM
authors.lastname: Pedersen
authors.forename: Billy B
authors.initials: BB
authors.lastname: Kristensen
authors.forename: Yvonne H
authors.initials: YH
authors.lastname: Rasmussen
authors.forename: Nicolai B
authors.initials: NB
authors.lastname: Foss
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging* / Q000294:innervation; D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000517:prevention & control*; D000077212:Ropivacaine; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D016387:Women's Health
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077212:Ropivacaine
keywords: Anesthesia and analgesia; anesthesia regional; hysterectomy; postoperative pain; randomized controlled trial