| Ultrasound-guided Transversus abdominal plane block with multimodal analgesia for pain management after total abdominal hysterectomy. | |
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MedLine Citation:
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PMID: 23291970 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Transversus abdominis plane (TAP) block has been shown to provide pain relief after abdominal procedures. However, TAP block combined with multimodal analgesia technique have not been assessed in a randomized controlled trial. This randomized, controlled, observer-blinded study was designed to evaluate the analgesic efficacy of bilateral ultrasound-guided TAP blocks with or without acetaminophen and non-steroidal anti-inflammatory drug (NSAID) combination. METHODS: Patients undergoing total abdominal hysterectomy were randomized to one of three groups. Group 1 (n = 25) received a TAP block and ketorolac 30 mg, IV at the end of surgery and then ketorolac plus paracetamol 650 mg, orally, every 6 h for 24 h. Group 2 (n = 24) received only TAP block at the end of surgery. Group 3 (n = 25) received ketorolac 30 mg, IV at the end of surgery and then ketorolac plus paracetamol 650 mg, orally, every 6 h for 24 h. All patients received IV-PCA morphine for 24-h, postoperatively. All patients received a standardized general anaesthetic technique and dexamethasone 4 mg and ondansetron 4 mg, IV for antiemetic prophylaxis. RESULTS: There were no statistically significant differences in pain at rest between the groups. However, the pain on coughing (dynamic pain) in Group 1 was significantly less variable, compared with the other two groups (P = 0.012). Opioid consumption and occurrences of nausea, vomiting, and rescue antiemetic were similar in three the groups. CONCLUSIONS: The combination of TAP block and acetaminophen and NSAID provided less variability in dynamic pain compared with either treatment alone. |
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Authors:
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Irina Gasanova; Erica Grant; Megan Way; Eric B Rosero; Girish P Joshi |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-6 |
Journal Detail:
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Title: Archives of gynecology and obstetrics Volume: - ISSN: 1432-0711 ISO Abbreviation: Arch. Gynecol. Obstet. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8710213 Medline TA: Arch Gynecol Obstet Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9068, USA, irina.gasanova@utsouthwestern.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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