Analgesic Efficacy of Ultrasound-Guided Lateral Transversus Abdominis Plane Block for Open Appendectomy: A Volume Comparison Randomized Control Trial Study

Pajina B, Tiyaprasertkul W, Thawillarp S and Nakazawa K

Nan Hospital, Nan, Thailand Bangkok Hospital Chiang Mai International, Chiang Mai, Thailand Department of Health Policy and Management, John Hopkins University, USA Department of Anesthesiology, Nihon university school of medicine, Tokyo

^*Correspondance to: Burapa Pajina 

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Abstract:

Introduction: The optimal volume of Local Anesthetic (LA) for the Transversus Abdominis Plane (TAP) block in managing postoperative pain remains controversial. This study aimed to determine whether smaller volumes of LA provide comparable analgesic efficacy during the postoperative period. Methods: Ninety patients undergoing open appendectomy were randomly assigned to three groups to receive a right lateral TAP block with 0.25% bupivacaine in different volumes: TAP1 received 10 ml, TAP2 received 15 ml, and TAP3 received 20 ml. The primary outcome was postoperative pain scores within the first 24 hours. Secondary outcomes included opioid consumption, time to first analgesic requirement, and any complications. Results: TAP3 exhibited significantly lower mean Visual Analog Scores (VAS) compared to TAP1 and TAP2 at all time points (p < 0.05), both during movement and at rest. Opioid consumption was also significantly lower in TAP3 compared to TAP1 and TAP2 (p < 0.05). Fewer patients in TAP3 requested additional analgesia. There were no significant differences in the time to first opioid requirement, and no complications related to the TAP block procedure were recorded. Conclusion: The volume of LA in a TAP block affects analgesic outcomes. While a 10 ml volume can provide adequate analgesia after open appendectomy, a 20 ml volume significantly reduces pain scores and opioid consumption.

Keywords:

TAP; Open appendectomy; Postoperative pain

Cite the Article:

Pajina B, Tiyaprasertkul W, Thawillarp S, Nakazawa K. Analgesic Efficacy of Ultrasound-Guided Lateral Transversus Abdominis Plane Block for Open Appendectomy: A Volume Comparison Randomized Control Trial Study. World J Surg Surgical Res. 2024; 7: 1582..