The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy.
OBJECTIVE
To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery.


METHODS
This study was completed at the Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls). After receiving general anesthesia, group T received a TAP block using 20 mL 0.25% bupivacaine on the operation side, whereas group C received a control block using 20 mL 0.9% Sodium chloride. During the first 24 hours after surgery, the patient pain was evaluated using the visual analogue scale (VAS) at rest and while coughing. Postoperative patient controlled analgesia morphine consumption, VAS scores, and side effects were recorded.


RESULTS
Of 34 patients, Group T (n=18) had significantly lower VAS pain scores than Group C (n=16) both at rest and while coughing. The total morphine consumed was  lower (7.7 ± 4.0) versus 21.6 ± 12.4 mg, p less than 0.001) in the 24 hours after surgery.


CONCLUSIONS
As part of a multimodal analgesic regime after varicocelectomy surgery, morphine consumption and VAS pain scores were significantly lower among those receiving 20 mL 0.25% bupivacaine administered for a TAP block than among controls.
Department of Anesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey. E-mail. dilekomur@yahoo.com.
Dilek
D
Ömür
Hüseyin
H
Oğuzalp
Hasan A
HA
Kiraz
Serpil
S
Ekin
Cabir
C
Alan
Ahmet R
AR
Ersay
Volkan
V
Hancı
D000293:Adolescent; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult
D009020:Morphine