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Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia

CONTEXT: Optimization and providing excellent quality of postoperative analgesia after total abdominal hysterectomy is a determinant factor of better clinical outcome, increases patient satisfaction, and allows early mobilization of the patient. AIMS: The aim of this study is to compare the postoper...

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Autores principales: Pratheeba, N., Remadevi, R., Raajesh, I. Joseph, Bhavani, V., Tripathy, D. K., Bhat, R. Ravindra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872899/
https://www.ncbi.nlm.nih.gov/pubmed/29628559
http://dx.doi.org/10.4103/aer.AER_201_17
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author Pratheeba, N.
Remadevi, R.
Raajesh, I. Joseph
Bhavani, V.
Tripathy, D. K.
Bhat, R. Ravindra
author_facet Pratheeba, N.
Remadevi, R.
Raajesh, I. Joseph
Bhavani, V.
Tripathy, D. K.
Bhat, R. Ravindra
author_sort Pratheeba, N.
collection PubMed
description CONTEXT: Optimization and providing excellent quality of postoperative analgesia after total abdominal hysterectomy is a determinant factor of better clinical outcome, increases patient satisfaction, and allows early mobilization of the patient. AIMS: The aim of this study is to compare the postoperative analgesic efficacy of wound site infiltration (WSI) and ultrasound-guided transversus abdominis plane block (TAPB) with 0.5% ropivacaine in lower abdominal surgeries under spinal anesthesia. SETTINGS AND DESIGN: This was a randomized controlled study. SUBJECTS AND METHODS: One hundred and ten patients undergoing lower abdominal surgeries were randomly allocated to two groups (WSI and TAP) of 55 patients in each. At the end of the surgical procedure, 2.5 mg/kg of the drug ropivacaine 0.5% was administered by an anesthesiologist through either of the routes of study. Visual analog score (VAS) assessment was done at every 30 min, for 1½ h, every 2 for 24 h postoperatively. Injection diclofenac sodium 75 mg intramuscularly was given whenever VAS was >3 as rescue analgesic. STATISTICAL ANALYSIS USED: Epi Info 7.0 version software for Windows was used. All analyses were performed using Kolmogorov–Smirnov test. Mann–Whitney test was applied to detect the difference between the two groups. P < 0.05 was considered statistically significant. RESULTS: Postoperative VAS scores in Group TAP were significantly reduced at 30 min, 1(st) h, 1 h 30 min, 2, 4, 6, 8, 10, 12, 18, and 24 h (P < 0.001). The total doses of rescue analgesics administered were also low in the Group TAP (1.41 ± 0.538) with P < 0.0001 in comparison to Group WSI (2.24 ± 0.637) with P < 0.001. CONCLUSIONS: The quality of analgesia along with lesser rescue analgesic requirement and their side effects makes the TAPB, a good and safer option for lower abdominal gynecological surgeries. Both WSI and USG TAPB are effective in providing postoperative analgesia as a part of multimodal analgesia in lower abdominal surgeries. However, in our study the quality of analgesia along with lesser rescue analgesic requirement and their side effects makes the TAPB, a good and safer option for lower abdominal gynecological surgeries.
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spelling pubmed-58728992018-04-06 Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia Pratheeba, N. Remadevi, R. Raajesh, I. Joseph Bhavani, V. Tripathy, D. K. Bhat, R. Ravindra Anesth Essays Res Original Article CONTEXT: Optimization and providing excellent quality of postoperative analgesia after total abdominal hysterectomy is a determinant factor of better clinical outcome, increases patient satisfaction, and allows early mobilization of the patient. AIMS: The aim of this study is to compare the postoperative analgesic efficacy of wound site infiltration (WSI) and ultrasound-guided transversus abdominis plane block (TAPB) with 0.5% ropivacaine in lower abdominal surgeries under spinal anesthesia. SETTINGS AND DESIGN: This was a randomized controlled study. SUBJECTS AND METHODS: One hundred and ten patients undergoing lower abdominal surgeries were randomly allocated to two groups (WSI and TAP) of 55 patients in each. At the end of the surgical procedure, 2.5 mg/kg of the drug ropivacaine 0.5% was administered by an anesthesiologist through either of the routes of study. Visual analog score (VAS) assessment was done at every 30 min, for 1½ h, every 2 for 24 h postoperatively. Injection diclofenac sodium 75 mg intramuscularly was given whenever VAS was >3 as rescue analgesic. STATISTICAL ANALYSIS USED: Epi Info 7.0 version software for Windows was used. All analyses were performed using Kolmogorov–Smirnov test. Mann–Whitney test was applied to detect the difference between the two groups. P < 0.05 was considered statistically significant. RESULTS: Postoperative VAS scores in Group TAP were significantly reduced at 30 min, 1(st) h, 1 h 30 min, 2, 4, 6, 8, 10, 12, 18, and 24 h (P < 0.001). The total doses of rescue analgesics administered were also low in the Group TAP (1.41 ± 0.538) with P < 0.0001 in comparison to Group WSI (2.24 ± 0.637) with P < 0.001. CONCLUSIONS: The quality of analgesia along with lesser rescue analgesic requirement and their side effects makes the TAPB, a good and safer option for lower abdominal gynecological surgeries. Both WSI and USG TAPB are effective in providing postoperative analgesia as a part of multimodal analgesia in lower abdominal surgeries. However, in our study the quality of analgesia along with lesser rescue analgesic requirement and their side effects makes the TAPB, a good and safer option for lower abdominal gynecological surgeries. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5872899/ /pubmed/29628559 http://dx.doi.org/10.4103/aer.AER_201_17 Text en Copyright: 2018 © Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Pratheeba, N.
Remadevi, R.
Raajesh, I. Joseph
Bhavani, V.
Tripathy, D. K.
Bhat, R. Ravindra
Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia
title Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia
title_full Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia
title_fullStr Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia
title_full_unstemmed Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia
title_short Comparison of Postoperative Analgesic Efficacy of Wound Site Infiltration and Ultrasound-guided Transversus Abdominis Plane Block with 0.5% Ropivacaine in Lower Abdominal Surgeries under Spinal Anesthesia
title_sort comparison of postoperative analgesic efficacy of wound site infiltration and ultrasound-guided transversus abdominis plane block with 0.5% ropivacaine in lower abdominal surgeries under spinal anesthesia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872899/
https://www.ncbi.nlm.nih.gov/pubmed/29628559
http://dx.doi.org/10.4103/aer.AER_201_17
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