Subcostal TAP Block Versus Lateral TAP Block for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

Abstract

Abstract Background Total abdominal hysterectomy surgeries are associated with severe postoperative pain. Effective pain management reduces the incidence of postoperative cardiac and pulmonary complications, decreases risk of postoperative deep venous thrombosis through early mobilization, provides patient satisfaction and reduces cost of hospital stay. A number of analgesic strategies have been adopted to minimize postoperative pain after abdominal surgeries. Studies suggest that abdominal wall blocks provide effective pain relief and faster postoperative rehabilitation than systemic analgesia. Objective To compare the effectiveness of subcostal versus lateral TAP blocks for post- operative pain management in patients undergoing total abdominal hysterectomy. Patients and Methods This study was a prospective randomised clinical study conducted in Ain Shams University Hospitals from October 2021 till October 2022 with a sample size of 100 patients undergoing total abdominal hysterectomy under general anaesthesia, divided into 2 groups, 50 patients each: Group A: Subcostal TAP Block group, Group B: lateral TAP Block group. Results These results demonstrated that performing postoperative bilateral subcostal TAP block in group (A) was associated with significant increase in heart rate, mean arterial blood pressure, pain scores and pethidine requirements postoperatively in comparison to bilateral lateral TAP block in group (B) which provided more effective analgesia than subcostal approach. Conclusion The quality of postoperative analgesia was more effective in patients received lateral TAP block than those received subcostal TAP block regarding hemodynamic changes, pain scores, doses of pethidine required for pain relief and postoperative mobilization.