Comparison of Epidural Analgesia with Transversus Abdominis Plane Analgesia for Postoperative Pain Relief in Patients Undergoing Lower Abdominal Surgery

Abstract

Introduction: Anesthesiologists play an important role in postoperative pain management. For analgesia after lower abdominal surgery, epidural analgesia and ultrasound-guided transversus abdominis plane (TAP) block are suitable options. The study aims to compare the analgesic efficacy of epidural analgesia and transverse abdominis plane (TAP) block. Material and Methods: In this study 165 patients undergoing lower abdominal surgery were divided into 3 groups. Group C (Control): spinal anesthesia with hyperbaric bupivacaine 15mg (3ml of 0.5%)+ intravenous infusion of 100 ml of NS over 15 min. Group E (Epidural): epidural catheter will be inserted before spinal block. At the end of the surgery, will receive 10 ml of 0.125% bupivacaine through the epidural catheter followed by removal of the catheter. Group T (TAP): at the end of surgery bilateral TAP block will be given and 20 ml of 0.125% bupivacaine will be injected and the spread of local anaesthetic solution visualised in real time through ultrasound. Assessment of the pain will be done using visual analog scale (VAS) Results: It was observed that comparison between the group C and group E was significant after 2 hours post-surgery. There was a large disparity between the groups T and Group C after 4 hours of surgery. The time to first rescue analgesic consumption was significantly higher in group E and group T with the majority of 41 (74.5%) patients of Group E satisfied. In present study, the pain score was measured based on the VAS scale in the three studied groups and it was found that the postoperative pain was lower significantly in the epidural group and TAP group as compared to control group (p<0.05) Conclusion: According to our study, in terms of postoperative analgesia, overall analgesic intake, and time to first rescue analgesia, along with similar nausea, vomiting, and time to hospital discharge, epidural analgesia performed better than TAP block.