Ali Akbar Nasiri - Department of Anesthesiology, Faculty of Medicine, University of Medical Sciences, Urmia, Iran

Background: 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.Materials and Methods: In this randomized double-blinded prospective clinical trial, ۶۴ patients undergoing laparotomy surgery were selected based on inclusion and exclusion criteria and were randomly divided into two groups with ۳۲ 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 ۲, ۶, ۱۲, ۱۸, and ۲۴ hours after surgery using visual analogue scale (VAS) criteria. Patients who scored their pain more than ۴ on the VAS for pain relief received ۲۵ mg of intravenous (IV) pethidine. Furthermore, potential complications, including nausea, vomiting, and dizziness were assessed and recorded in both groups.Results: Mean pain severity ۲, ۴, ۶, ۱۲, ۱۸, and ۱۸ hours after surgery was significantly lower in the TAP-block group than in the control group (P=۰.۰۰۱). The mean dose of pethidine received in TAP block patients was ۲۸.۹۰±۱۹.۱۶ and ۶۰.۹۳±۱۴.۱۱ in the control group, which showed a significant difference (P=۰.۰۰۱). Moreover, the mean time to the first dose of pethidine in patients in the TAP block group and the control group was ۱۵.۳۶±۳.۵۶ and ۸.۴۳±۴.۲۸ hours after surgery (P=۰.۰۰۱). In addition, the incidence of nausea and vomiting was lower in the TAP group than in the control group.Conclusion: Ultrasound-guided TAP block can control post-laparotomy pain and reduce opioid use during hospitalization.

Ropivacaine, Laparotomy, Transversus abdominis plane block, Anesthesia, Pain