TY - JOUR

T1 - Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy

T2 - a randomized, double-blind, placebo-controlled trial

AU - Røjskjaer, Jesper O

AU - Gade, Erik

AU - Kiel, Louise B

AU - Lind, Morten N

AU - Pedersen, Lars Møller

AU - Kristensen, Billy B

AU - Rasmussen, Yvonne H

AU - Foss, Nicolai B

N1 - © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

PY - 2015

Y1 - 2015

N2 - OBJECTIVE: To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen.DESIGN: A randomized, double-blind, placebo-controlled trial following the CONSORT criteria.SETTING: Hvidovre University Hospital.PATIENTS: Forty-six women scheduled for total abdominal hysterectomy.INTERVENTION: Women received either ropivacaine 0.75%, 20 mL (n = 24) or 0.9% saline, 20 mL (n = 24) in the transversus abdominis plane on each side.MAIN OUTCOME MEASURES: Primary outcome was the 24-h postoperative morphine consumption. Secondary outcomes were pain scores at rest and during coughing, postoperative nausea and vomiting at 1, 2, 4, 6, 8, and 24 h, and time to first mobilization.RESULTS: There was no difference in the mean 24-h postoperative morphine consumption between the two groups (p = 0.733). The ropivacaine group had significantly lower median pain scores at 1 h (p = 0.008) and 2 h (p = 0.027) postoperatively at rest and at 8 h (p = 0.028) during coughing. There was no significant difference in other secondary outcomes.CONCLUSION: There was no reduction in 24-h morphine consumption when using an ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period.

AB - OBJECTIVE: To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen.DESIGN: A randomized, double-blind, placebo-controlled trial following the CONSORT criteria.SETTING: Hvidovre University Hospital.PATIENTS: Forty-six women scheduled for total abdominal hysterectomy.INTERVENTION: Women received either ropivacaine 0.75%, 20 mL (n = 24) or 0.9% saline, 20 mL (n = 24) in the transversus abdominis plane on each side.MAIN OUTCOME MEASURES: Primary outcome was the 24-h postoperative morphine consumption. Secondary outcomes were pain scores at rest and during coughing, postoperative nausea and vomiting at 1, 2, 4, 6, 8, and 24 h, and time to first mobilization.RESULTS: There was no difference in the mean 24-h postoperative morphine consumption between the two groups (p = 0.733). The ropivacaine group had significantly lower median pain scores at 1 h (p = 0.008) and 2 h (p = 0.027) postoperatively at rest and at 8 h (p = 0.028) during coughing. There was no significant difference in other secondary outcomes.CONCLUSION: There was no reduction in 24-h morphine consumption when using an ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period.

KW - Abdominal Muscles

KW - Adult

KW - Amides

KW - Analgesia, Patient-Controlled

KW - Analgesics, Opioid

KW - Anesthetics, Local

KW - Double-Blind Method

KW - Female

KW - Humans

KW - Hysterectomy

KW - Middle Aged

KW - Morphine

KW - Pain, Postoperative

KW - Treatment Outcome

KW - Ultrasonography, Interventional

KW - Women's Health

U2 - 10.1111/aogs.12567

DO - 10.1111/aogs.12567

M3 - Journal article

C2 - 25556539

VL - 94

SP - 274

EP - 278

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

IS - 3

ER -