The analgesic efficacy of ultrasound-guided transversus abdominis plane block with 2% lidocaine in early postoperative period after lower abdominal surgery

Song, In Kyung; Kim, Chi Hyo; Han, Jong In; Lee, Guie Yong; Chung, Rack Kyung; Baik, Hee Jung; Kim, Se Hee

Clinical Research

Spinal Pain

Anesthesia and Pain Medicine 2012;7(4):280-285.
Published online October 31, 2012.

The analgesic efficacy of ultrasound-guided transversus abdominis plane block with 2% lidocaine in early postoperative period after lower abdominal surgery

In Kyung Song, Chi Hyo Kim, Jong In Han, Guie Yong Lee, Rack Kyung Chung, Hee Jung Baik, Se Hee Kim

Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. 120060@ewha.ac.kr

Abstract

BACKGROUND
Transversus abdominis plane (TAP) block is a new regional anesthetic technique for postoperative pain control after lower abdominal surgery. We evaluated the analgesic efficacy of ultrasound-guided (US-) TAP block in patients undergoing lower abdominal surgery.
METHODS
Thirty American Society of Anesthesiologists physical status I or II patients between 20-80 years of age undergoing lower abdominal surgery were randomized to receive standard care (n = 15) including intravenous patient-controlled analgesia (IV-PCA), or to undergo bilateral US-TAP block adjunctively (n = 15). A standard general anesthetic technique was used. After induction of anesthesia, bilateral US-TAP block was performed using total 30 ml of 2% lidocaine. Each patient was assessed postoperatively at 20, 30, and 60 min in postanesthesia care unit (PACU) and at 6, 12, and 24 h in ward for pain scores using verbal numerical rating scale (VNRS), analgesic requirements, quality of sleep, and complications.
RESULTS
US-TAP block significantly reduced VNRS pain scores at 20, 30, and 60 min postoperatively (P < 0.001). The US-TAP block group required significantly fewer remifentanil intraoperatively (P < 0.05). Additional analgesic requirements were significantly lower in both PACU and ward (P < 0.05) in the US-TAP block group. There were no statistically significant between-group differences in total infused volume of IV-PCA, time to first requirement of analgesics in ward, and quality of sleep.
CONCLUSIONS
US-TAP block with 2% lidocaine provided superior analgesia after lower abdominal surgery especially in the first 60 postoperative min when used as a component of a multimodal analgesic regimen.

Key Words: Abdominal wall, Analgesia, Nerve block, Postoperative pain, Ultrasonography