1. Transversus Abdominis Plane Block for Postoperative Analgesia in Patients Undergoing Total Laparoscopic Hysterectomy: A Randomized, Controlled, Observer-Blinded Trial.
- Author
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Ghisi D, Fanelli A, Vianello F, Gardini M, Mensi G, La Colla L, and Danelli G
- Subjects
- Adult, Analgesia, Patient-Controlled methods, Analgesics, Opioid administration & dosage, Anesthetics, Local adverse effects, Bupivacaine administration & dosage, Bupivacaine adverse effects, Elective Surgical Procedures, Female, Humans, Hysterectomy methods, Italy, Levobupivacaine, Middle Aged, Morphine administration & dosage, Nerve Block adverse effects, Pain Measurement, Pain, Postoperative diagnosis, Pain, Postoperative etiology, Pain, Postoperative physiopathology, Time Factors, Treatment Outcome, Abdominal Muscles innervation, Anesthetics, Local administration & dosage, Bupivacaine analogs & derivatives, Hysterectomy adverse effects, Laparoscopy adverse effects, Nerve Block methods, Pain Threshold drug effects, Pain, Postoperative prevention & control
- Abstract
Background: In this randomized, controlled, observer-blinded study, we evaluated analgesia provided by transversus abdominis plane (TAP) block after elective total laparoscopic hysterectomy in terms of reduced postoperative morphine consumption as the primary end point., Methods: Fifty-two patients were randomly divided into 2 groups: patients in group T (TAP, n = 26) received an ultrasound-guided bilateral TAP block with 40 mL of 0.375% levobupivacaine and morphine patient-controlled analgesia, whereas patients in group C (control, n = 26) received morphine patient-controlled analgesia. Secondary outcomes included pain measurements (Numeric Rating Scale from 0 to 10) during the first 24 hours postoperatively, times to postanesthesia care unit discharge, times to surgical ward discharge, incidence of postoperative nausea and vomiting, functional capacity measurements in terms of 2-minute walking test, and first oral solid intake., Results: Demographic and anthropometric variables were similar in the 2 groups. The total dose of morphine consumed by patients during postanesthesia care unit stay was 6 (0-8) mg in group T vs 8 (5.5-8.5) mg in group C (P = 0.154). Postoperative morphine consumption during the first 24 hours was 10.55 ± 10.24 mg in group C vs 10.73 ± 13.45 mg in group T (P = 0.950). The 95% confidence interval of the difference between means of 24-hour morphine consumption was -7.45 to +7.09. The 2 groups were comparable. There were no significant differences in secondary outcome variables between groups., Conclusions: TAP block did not reduce morphine consumption during the first postoperative 24 hours after elective total laparoscopic hysterectomy.
- Published
- 2016
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