Indian Journal of Clinical Anaesthesia


An evaluation of (0.25%) Bupivacaine Vs (0.5%) Ropivacaine for postoperative analgesia using ultrasound guidedtransversus abdominis plane block for abdominal surgeries: A comparative study


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Author Details: Neha Sharma, Nandita Mehta, Shikha Sharma

Volume : 3

Issue : 4

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 635

Article End Page : 639


Abstract

Background: Transversus Abdomin is Plane (TAP) Block is a regional analgesic technique. It provides analgesia after abdominal surgery particularly where parietal wall pain forms major component of pain. It allows sensory blockade of abdominal wall skin and muscles via local anaesthetic deposition above Transversus Abdominis muscle(TAM). We evaluated efficacy of Bupivacaine and Ropivacaine in Ultrasound guided TAP Block for post-operative analgesia in abdominal surgeries like hernia repair, open cholecystectomy in a hospital based, double blind, prospective, randomized clinical trial.
Method: 60 adult patients undergoing elective abdominal surgery under general anaesthesia were included in this study and were randomly divided into two groups according to computer generated table of randomization. After induction of anaesthesia, TAP Block unilateral or bilateral(depending upon nature of incision of surgery) was performed using 15 ml of 0.5% Ropivacaine or 0.25% Bupivacaine each side. Each patient was assessed intra-operatively for haemodynamic parameters like HR, SBP, DBP, MBP and SPO2 at 0, 5, 10, 20 minutes (m) and then after every 10m till the end of surgery. Post-operatively patients were assessed for pain with VAS score at 0m, 30 m, 4, 8, 12, 18 and 24 hours (h) by a blinded investigator.
Results: Intra-operatively haemodynamic parameters remained stable and comparable in both the groups. Mean duration of analgesia in Ropivacaine group and Bupivacaine group was 12.61±5.13hrs and 9.92±4.81h respectively, the difference was found to be statistically significant.
Conclusion: 0.5% Ropivacaine provided longer duration of analgesia than 0.25% Bupivacaine when used in Ultrasound guided TAP Block on patients undergoing abdominal surgeries. TAP Block via lumbar approach using Ultrasonography provides better pain relief especially in lower abdominal surgeries as compared to upper abdominal surgeries. There were no complications attributable to TAP Block or drugs under study.

Keywords: TAP block, Ropivacaine, Bupivacaine, Postoperative analgesia