Effect of Ultrasound-Guided Transversus Abdominal Plane Block on Postoperative Pain After Laparotomy Abdominal Surgery

Transversus abdominis plane (TAP) block is used to manage pain in patients undergoing laparotomy abdominal surgery. This study aimed to investigate the effect of ultrasound-guided TAP block on postoperative pain and complications in patients undergoing laparotomy abdominal surgery.

In this randomized double-blinded prospective clinical trial, 64 patients undergoing laparotomy surgery were selected based on inclusion and exclusion criteria and were randomly divided into two groups with 32 patients in each group. General anesthesia was induced in all patients. At the end of the surgery, a TAP block was performed under ultrasound guidance in the intervention group, and the control group received no intervention. The severity of pain was assessed 2, 6, 12, 18, and 24 hours after surgery using visual analogue scale (VAS) criteria. Patients who scored their pain more than 4 on the VAS for pain relief received 25 mg of intravenous (IV) pethidine. Furthermore, potential complications, including nausea, vomiting, and dizziness were assessed and recorded in both groups.

Mean pain severity 2, 4, 6, 12, 18, and 18 hours after surgery was significantly lower in the TAP-block group than in the control group (P = 0.001). The mean dose of pethidine received in TAP block patients was 28.90 ± 19.16 and 60.93 ± 14.11 in the control group, which showed a significant difference (P = 0.001). Moreover, the mean time to the first dose of pethidine in patients in the TAP block group and the control group was 15.36 ± 3.56 and 8.43 ± 4.28 hours after surgery (P = 0.001). In addition, the incidence of nausea and vomiting was lower in the TAP group than in the control group.

Ultrasound-guided TAP block can control post-laparotomy pain and reduce opioid use during hospitalization.