Analgesic effects of TAP block among open appendectomy patients and the need of postoperative pethidine for Pain Management: A randomised controlled trial

Shahmoradi, Mohammad Kazem and Besharatifar, Gholamreza and Taheri, Hamid Reza (2020) Analgesic effects of TAP block among open appendectomy patients and the need of postoperative pethidine for Pain Management: A randomised controlled trial. International Journal of Surgery Open.

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Abstract

Background: The transversus abdominis plane (TAP) block is an effective method to reduce postoperative pain and need of analgesics following abdominal surgeries. Objective: The aim of this study is to evaluate the effects of Marcaine (0.5% bupivacaine) TAP block on postoperative pain, patient recovery and the need of pethidine as an analgesic, following open appendectomy. Method: In this randomized blinded study, 96 patients undergoing open appendectomy were randomly divided into two equal groups of 48 patients. Group A received 20 cc of Marcaine (0.5% bupivacaine) under ultrasound guidance as TAP block and group B received 20 cc of normal saline as a control group. Under general anesthesia, patients underwent open appendectomy. The visual analogue scale (VAS) was used to measure postoperative pain along with the patient's need of pethidine, patient's satisfaction, duration of hospitalization, complications and recovery time (time to resume walking). Result: The two groups were had no statistically significant difference in terms of age, sex and BMI, P < 0.99, respectively. After adjusting the duration of the surgery and incision size, the duration of hospitalization, time of resume walking, patient satisfaction based on postoperative pain and the need of pethidine at 1, 3, 6, 12, 24 and 48 h were significantly different in the two groups, P < 0.001. Additionally, postoperative complications were not significantly different among the two groups. Conclusion: The results of the study indicate that TAP block before open appendectomy with Marcaine (0.5% bupivacaine) is effective to manage postoperative pain and is associated reduced need of postoperative analgesia and hospitalization.

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