Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.19, sa.4, ss.208-212, 2011 (Scopus)
Background: Transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing abdominal surgery. We evaluated the analgesic efficacy of the ultrasound-guided TAP block with compared epidural analgesia in patients undergoing total abdominal hysterectomy under spinal anesthesia. Methods: A randomized, double-blind trial was performed at a tertiary hospital. Forty patients were randomized to receive spinal anesthesia and epidural analgesia either without (Group I, n=20) or with TAP block (Group II, n=20). Bilateral TAP block was performed with bupivacaine 0.25%. All participants received spinal anesthesia with bupivacaine, followed by postoperative patient-controlled epidural levobupivacaine+fentanyl. Postoperative demand of levobupivacaine+fentanyl, average pain scores, nausea, vomiting, urinary retention, hypotension, satisfaction with pain relief was recorded. Results: Total levobupivacaine + fentanyl use in 48 hours was reduced in group II (mean ± SD Levobupivacaine: 150±43 mg and Fentanyl: 240±68 μg) compared with group I (mean ± SD Levobupivacaine: 428±90 mg and Fentanyl: 685±145 μg) (p<0.05). VAS scores were significantly lower in group II at all times, than in group I (p<0.05). Conclusions: The ultrasound-guided TAP block reduces levobupivacaine+fentanyl requirements, decreases pain scores and increases patient satisfaction after total abdominal hysterectomy.