Background: The study was done to assess the postoperative analgesic efficacy of ultrasound-guided continuous transverses abdominis plane block,
continuous lumbar paravertebral block and a continuous lumbar epidural
block in patients undergoing lower abdominal surgeries (unilateral inguinal
hernia repair). We compared their analgesic efficacy over the first 48 hour
postoperative, in a randomized, single-blind study in 120 patients divided into four equal groups, 30 patients in each group. Methods: 120 patients randomly assigned into four equal groups, with 30 patients in each group. Group
T received ultrasound-guided transverses abdominis plane block with 20 ml
of bupivacaine 0.25% followed by continuous infusion of bupivacaine 0.125%
(0.1 ml/kg/hr) and group P received ultrasound-guided continuous lumbar
paravertebral block with bupivacaine 0.25% bolus dose 20 ml, followed by
continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr). Group E received
continuous lumbar epidural infusion of bupivacaine 0.25% bolus dose 20 ml,
followed by continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr) and
group C received normal saline bolus dose 20 ml, followed by continuous infusion of normal saline (0.1 ml/kg/hr). General anesthesia induced with fentanyl 1 - 2 μg/kg and propofol 1 - 3 mg/kg followed by atracurium 0.5 mg/kg.
At the end of the surgical procedure, we activated the regional block with recording of parameters in the postoperative period each patient was assessed
for visual analog scale (VAS) at rest and on movement, analgesic consumption, vital signs and presence of complications (nausea, vomiting, sedation),
and postoperative patient satisfaction all data collected postoperatively by a
blinded investigator at one, two, 6, 12, 24 and 48 hours postoperatively. Results: Postoperative analgesic efficacy is more in group E than group P and
How to cite this paper: Elmeliegy, M.
(2018) Comparison of Postoperative Analgesic Efficacy between Continuous Transversus Abdominis Plane Block, Lumbar
Paravertebral and Epidural Blocks after
Abdominal Surgeries. Open Journal of
Anesthesiology, 8, 267-279.
https://doi.org/10.4236/ojanes.2018.811027
Received: August 10, 2018
Accepted: November 5, 2018
Published: November 8, 2018
Copyright © 2018 by author and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access
DOI: 10.4236/ojanes.2018.811027 Nov. 8, 2018 267 Open Journal of Anesthesiology
M. Elmeliegy
group T, the latter is least effective in pain control. Also in group E the postoperative analgesic consumption is lower than in group P and group T, regarding complications as nausea and vomiting more recorded in epidural
than the other two groups. Conclusion: Regarding postoperative analgesic
efficacy, the continuous lumbar epidural block is more effective than continuous paravertebral and continuous transverses abdominis plane block, but
regarding complications, there was a higher incidence in epidural group than
other two groups |
