Efficacy of ultrasound-guided transversus abdominis plane block in laparoscopic hysterectomy. Clinical trial.
OBJECTIVE
Transversus abdominis plane block is a regional anaesthesia technique that has proven to be effective for postoperative pain reduction in different abdominal surgical procedures. This study evaluated its efficacy on post laparoscopic hysterectomy pain intensity and analgesic consumption.


METHODS
Randomized controlled trial which included 40 patients scheduled for laparoscopic hysterectomy, enrolled in 2 groups: transversus abdominis plane block+systemic analgesia (Group 1; n=20), versus systemic analgesia (Group 2; n=20). Opioid consumption within the first 24 postoperative hours, pain intensity scores at 60min, 2, 8 and 24h after surgery, adverse events related to systemic analgesia and time to hospital discharge were evaluated and registered.


RESULTS
We found no differences between both groups in opioid consumption (10mg vs. 7mg; P=.2) and pain scores (NVS) within the first 24 postoperative hours, at 60min (3 vs. 5; P=.65), 120min (0 vs. 2; P=.15), 8 and 24h (0 vs. 0; P>.50) for the last 2 points in time analysed. Adverse events related to medication and time to hospital discharge showed similar results.


CONCLUSIONS
Adding a transversus abdominis plane block technique to opioid PCA does not seem to improve postoperative pain management in laparoscopic hysterectomy. Patient preparation time and costs could be incremented and complications (although rare) related to the technique could appear.
Servicio de Anestesiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: guardabassidiego@hotmail.com.
D S
DS
Guardabassi
Servicio de Anestesiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
S
S
Lupi
Servicio de Anestesiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
R
R
Agejas
Servicio de Anestesiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
J M
JM
Allub
Servicio de Anestesiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
G
G
García-Fornari
D000009:Abdominal Muscles / Q000000981:diagnostic imaging; D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D016037:Single-Blind Method; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
Analgesia postoperatoria; Anestesia regional; Bloqueo del plano transverso abdominal; Cirugía laparoscópica; Consumo de opioides; Dolor postoperatorio; Laparoscopy; Opioid consumption; Postoperative analgesia; Postoperative pain; Regional anaesthesia; Transversus abdominal plane block