Single Injection Unilateral Ultrasound Guided Transversus Abdominis Plane Block versus Local Anaesthetic Infiltration for Post-Operative Analgesia after Nephrectomy in a Tertiary Care Hospital, Raipur - A Randomised Single-Blind Study

Abstract

BACKGROUND This was a randomised single-blinded study. It was designed to compare the superiority of infiltration analgesia and ultrasound guided unilateral transversus abdominis plane block on pain scores, total opioid consumption, and assess the side effects of opioid after nephrectomy. METHODS This study included 56 patients aged between 18 - 50 years with American Society of Anaesthesiologists (ASA) status II - III who underwent nephrectomy. Patients were broadly placed in 2 groups, who underwent transversus abdominis plane block for postoperative analgesia as Group TAP and infiltration analgesia as Group LA. Visual analog scale was used for post-operative pain evaluation at the 0, 2, 4, 6, 8, 12, 24 hours. Patients with VAS of more than 3 were given tramadol 1 mg / Kg. In the first 24 hours postoperatively, total analgesic consumption, rate of nausea vomiting and other side effect of patients were recorded and results were evaluated statistically. RESULTS Demographic characteristics were similar in the two groups; post-operative visual analog scale (VAS) score were significantly less in the transversus abdominis plane block group at the 6th, 8th and 12th hours compared to the infiltration analgesia group. The total analgesic consumption and nausea-vomiting rates were significantly lower in the transversus abdominis plane block. CONCLUSIONS In our study transversus abdominis plane block method was found superior to infiltration analgesia method on post-operative pain management in unilateral nephrectomy. In conclusion, we recommend the transversus abdominis plane block to be effective for post-operative analgesia after unilateral nephrectomy. KEYWORDS Nephrectomy, Postoperative Pain Management, Transversus Abdominis Plane Block, Infiltration Analgesia, opioid Consumption