Study to evaluate transversus abdominis plane (TAP) block with ropivacaine in appendectomy patients by total requirement of diclofenac as a postoperative analgesia drug

Abstract

Background and Aim: Transversus abdominis plane (TAP) block is a regional anesthesia technique that provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall. This prospective, randomized, double blind, controlled study was carried out in 60 ASA I and II patients, between 20 to 65 years of age who underwent appendectomy.
Methodology: Participants were randomly divided into two different groups. Study group (n=30) patients received TAP block with injection ropivacaine (0.5%) 20 ml and Control group (n=30) patients did not receive TAP block and were given injection diclofenac on demand for post-operative analgesia as per institute protocol for routine surgery. Assessment of motor and sensory block, pulse, blood pressure, requirement of postoperative diclofenac, and complications were done and recorded.
Results: This prospective study was carried out in 60 ASA I and II patients. No significant difference was observed between two groups in terms of demographic data. Sensory block [thoracic] was almost equivalent in both groups at the end of surgery or at time of the TAP block in both groups, T-8.2 ± 1.095 vs. T-7.867 ± 1.04 (p = 0.232) in Study and Control groups respectively. VAS score was significantly higher in control group as compared to the study group at all times. First dose of rescue analgesia required was at 1140.66 ± 294.89 and 210.33 ± 92.45 min in study group and control group respectively. Total dose of diclofenac consumption was 82.5 ± 22.88 and 212.5 ± 34.58 mg respectively in study and control groups, which showed that Diclofenac consumption was significantly decreased in study group. Heart rates and mean BP were equivalent in both groups. There were no complications related to the TAP block in both of the groups.