title: Postoperative pain relief following hysterectomy: A randomized controlled trial.
abstract: BACKGROUND
  Women experience moderate to severe postoperative pain following total abdominal hysterectomy (TAH). The transversus abdominis plane (TAP) block is a new modality for providing postoperative pain relief in these patients.
  
  
  METHODS
  The present study was a single center, prospective randomized trial. After the Institutional Ethics Committee approval and informed consent, patients were randomized to either epidural group: Epidural block placement + general anesthesia (GA) or TAP group: Single shot TAP block + GA. Patients in both the groups received standard general anesthetic technique and intravenous tramadol patient-controlled analgesia in the postoperative period. Patients were monitored for tramadol consumption, visual analog scale (VAS) both at rest and on coughing, hemodynamics, and side effects at 0, 2, 4, 6, 8, 12, and 24 h postoperatively.
  
  
  RESULTS
  The total consumption of tramadol in 24 h was greater in TAP group as compared to epidural group (68.8 [25.5] vs. 5.3 [11.6] mg, P < 0.001). The VAS scores at rest and on coughing were higher in TAP group as compared to the epidural group at 6, 8, 12, and 24 h postoperatively (P < 0.05). None of the patients in either group had any adverse effects.
  
  
  CONCLUSIONS
  Epidural analgesia provided greater tramadol-sparing effect with superior analgesia postoperatively as compared to TAP block in patients up to 24 h following TAH.
authors: Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors: K P
authors: KP
authors: Raghvendra
authors: Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors: Deepak
authors: D
authors: Thapa
authors: Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors: Sukanya
authors: S
authors: Mitra
authors: Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors: Vanita
authors: V
authors: Ahuja
authors: Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors: Satinder
authors: S
authors: Gombar
authors: Department of Obstetric and Gynaecology, Government Medical College and Hospital, Chandigarh, India.
authors: Anju
authors: A
authors: Huria
keywords: Epidural block; postoperative pain relief; total abdominal hysterectomy; transversus abdominis plane block