TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK REDUCES POSTOPERATIVE MORHPINE REQUIRMENT AND POSTOPERATIVE SEDATION SCORES IN PATIENTS UNDERGOING LOWER ABDOMINAL OPERATIONS: A PROSPECTIVE STUDY.

BACKGROUND: Transversus abdominis plane (TAP) block is a regional anaesthetic technique which has recently gained popularity. It is being used for postoperative analgesia for upper and lower abdominal surgeries. Local anaesthetic is deposited in the neuro-fascial plane between the internal oblique and the transversus abdominis muscle. We carried on this study to assess the postoperative pain and sedation scores in patients undergoing lower abdominal surgeries in a randomized controlled, double blind study. METHODS: 40 patients scheduled to undergo inguinal hernia repair or appendicectomy were randomly selected. All the patients received a general anaesthetic for the proposed surgery. Patients were divided into two groups, a Tab block group in which the patients were given a Tap block after the induction of general anaesthetic and a control group in which the patients did not receive the Tap block. Patients in both the groups received Inj acetaminophen 1gm every 8 hourly and Inj morphine 0.05mg/kg intermittently every time the patient complaint of pain postoperatively. Patients in both the groups were assessed for postoperative morphine requirements and sedation scores at 2,6,12 and 24 hours. RESULTS: There was a significant difference in the verbal analogue scores for pain as well as the visual analogue scores for sedation in both the groups. Postoperative morphine requirement (24hours) was significantly reduced in the patients who did not receive the Tap block as compared to the patients who receive the block (17.5mg Vs 7mg). Postoperative sedation scores were also significantly less in the Tap block group as compared to the control group. CONCLUSIONS: Tap block provides a highly effective analgesia in patients undergoing lower abdominal surgery. It reduces the morphine requirement and sedation scores in the 24 hours postoperative period.