The use of ultrasound-guided transversus abdominis plane blocks for total abdominal hysterectomy: A double-blind, controlled trial

Abstract

Objectives: This study investigated the postoperative analgesic efficacy of bilateral ultrasound-guided transversus abdominis plane (TAP) blocks, in patients undergoing total abdominal hysterectomy.

Design, setting and subjects: This was a prospective, randomised, double-blind, controlled study. Thirty patients were allocated to two groups; a TAP block group (n = 15) and a placebo group (n = 15). The TAP blocks were performed with 0.25% bupivacaine. The placebo group received sham blocks with normal saline, post induction of anaesthesia. Postoperatively,
patients received patient-controlled intravenous morphine for analgesia.

Outcome measures: The primary outcome was morphine consumption during the first 24 hours postoperatively. Secondary outcomes were  adequacy of pain relief, as assessed by pain scores at 0, 6 and 24 hours postoperatively, and side-effects.

Results: Our study showed a significant between-group difference in morphine requirements (5.2 ± 3.9 vs. 9.7 ± 4.3 mg, p = 0.007, and 12.9 ± 8.9 mg vs. 25 ± 12.1 mg, p = 0.006) for the TAP group, compared with the placebo group at six and 24 hours, respectively. There were no significant between-group differences in pain scores. There were no complications
with any of the blocks.

Conclusion: Bilateral ultrasound-guided TAP blocks significantly reduced postoperative morphine consumption in a multimodal postoperative analgesia regimen for abdominal hysterectomy.