- Visibility 188 Views
- Downloads 22 Downloads
An evaluation of (0.25%) Bupivacaine Vs (0.5%) Ropivacaine for postoperative analgesia using ultrasound guidedtransversus abdominis plane block for abdominal surgeries: A comparative study
- Author Details:
-
Neha Sharma
-
Nandita Mehta
-
Shikha Sharma
Background: Transversus Abdomin is Plane (TAP) Block is a regional analgesic technique. It provides analgesia after abdominal surgery particularly where parietal wall pain forms major component of pain. It allows sensory blockade of abdominal wall skin and muscles via local anaesthetic deposition above Transversus Abdominis muscle(TAM). We evaluated efficacy of Bupivacaine and Ropivacaine in Ultrasound guided TAP Block for post-operative analgesia in abdominal surgeries like hernia repair, open cholecystectomy in a hospital based, double blind, prospective, randomized clinical trial.
Method: 60 adult patients undergoing elective abdominal surgery under general anaesthesia were included in this study and were randomly divided into two groups according to computer generated table of randomization. After induction of anaesthesia, TAP Block unilateral or bilateral(depending upon nature of incision of surgery) was performed using 15 ml of 0.5% Ropivacaine or 0.25% Bupivacaine each side. Each patient was assessed intra-operatively for haemodynamic parameters like HR, SBP, DBP, MBP and SPO2 at 0, 5, 10, 20 minutes (m) and then after every 10m till the end of surgery. Post-operatively patients were assessed for pain with VAS score at 0m, 30 m, 4, 8, 12, 18 and 24 hours (h) by a blinded investigator.
Results: Intra-operatively haemodynamic parameters remained stable and comparable in both the groups. Mean duration of analgesia in Ropivacaine group and Bupivacaine group was 12.61±5.13hrs and 9.92±4.81h respectively, the difference was found to be statistically significant.
Conclusion: 0.5% Ropivacaine provided longer duration of analgesia than 0.25% Bupivacaine when used in Ultrasound guided TAP Block on patients undergoing abdominal surgeries. TAP Block via lumbar approach using Ultrasonography provides better pain relief especially in lower abdominal surgeries as compared to upper abdominal surgeries. There were no complications attributable to TAP Block or drugs under study.
Keywords: TAP block, Ropivacaine, Bupivacaine, Postoperative analgesia
References
- Aasvang E, Kehlet H. Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 2005;95(1):69–76.
- Rafi AN. Abdominal field block: a new approach via lumbar triangle. Anaesthesia 2001;56(10):1024-30.
- Buchi J, Perlia X. Structure‐activity relations and physiochemical properties of local anesthetics. In: International Encyclopaedia of Pharmacology and Therapeutics, Section 8, Vol. 1, Local Anesthetics. Oxford: Pergamon Press, 1971;39–130.
- Wildsmith JAW. Relative potencies of ropivacaine and bupivacaine. Anesthesiology 2000;92:283.
- Capogna G, Celleno D, Fusco P et al. Relative potencies of bupivacaine and ropivacaine for analgesia in labour. Br J Anaesth 1999;82:371–3.
- Hebbard P, Fujiwara Y, Shibata Y et al. Ultrasound- guided transversus abdominis plane (TAP) block. Anaesth Intensive Care. 2007;35:616–8.
- Tran T M, Ivanusic J J, Hebbard P, Barrington MJ. Determination of spread of injectable after ultrasound- guided transverses abdominis plane block: A cadaveric study.Br J Anaesth 2009;102:123-74.
- Kai Li, Longyun Li, Ming Gao et al. Application of ultrasound-guided subcostal transversus abdominis plane block in gastric cancer patients undergoing open gastrectomy. Int J Clin Exp Med. 2015; 8(8): 13976–82.
- Mukhtar K, Singh S. Transervusabdominis plane block for laproscopic surgery. Br J Anaesth 2009;102:143- 4.
- Ronald D. Miller editor, 7 th edition Miller’s Anesthesia, History of Anesthetic practice p20-21,929,33-4.
- Clarkson CW, Hondeghem LM. Mechanism for bupivacaine depression of cardiovascular conduction: fast block of sodium channels during the action potential with slow recovery from block during diastole. Anesthesiology 1985;62:396–405.
- Aberg G. Toxicological and local anaesthetic effects of optically active isomers of two local anaesthetic compounds. Acta Pharmacol Toxicol 1972;31:444–50.
- Neha Fuladi, Shubhada Deshmukh, Anjali Bhur. Comparative study of bupivacaine 0.25% versus ropivacaine 0.5% in transversus abdominis plane block for postoperative analgesia in lower abdominal surgeries: a randomised controlled trial. Journal of Evolution of Medical and Dental Sciences 2014;3(17):4569-76.
- Shibata Y, Sato Y, Fujiwara Y, Komatsu T. Transversus Abdominis Plane Block. Anesthesia and Analgesia 2007; 105: 883.
- Farooq M, Carey M. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Regional Anesthesia and Pain Medicine. 2008;33(3):274–5.
- Frigon C, Mai R, Valois-Gomez T, Desparmet J. Bowel hematoma following Iliohypogastricilioinguinal nerve block. Pediatric Anaesthesia 2006;16: 993-6.
- Mc Donnell JG, Curley G, Carney J, Bentom A et al. The analgesic efficacy of transversus abdominus plane block after caesarean delivery: a randomized controlled trial. AnesthAnalg. 2008; 106(1):186-91.
- Lancaster P, Chadwick M. Liver trauma secondary to ultrasound-guided transversus abdominis plane block. British Journal of Anaesthesia. 2010;104(4):509–
- Kato N, Fujiwara Y, Harato M et al. Serum concentration of lidocaine after transversus abdominis plane block. Journal of Anesthesia. 2009;23(2):298–300.
- N. Yu, X. Long, J.R. Lujan-Hernandez et al Transversus abdominis-plane block versus local anesthetic wound infiltration in lower abdominal surgery: a systematic review and meta-analysis of randomized controlled trial. BMC Anesthesiology, 14 (2014); 14: 121– 9.
- Kawahara R, Tamai Y, Yamasaki K et al. The analgesic efficacy of ultrasound-guided transverses abdominis plane block with mid-axillary approach after gynecologic laparoscopic surgery: A randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2015 ; 31 (1):67-71.
- Ripolles J, Mezquita SM, Abad A et al. Analgesic efficacy of the ultrasound-guided blockade of the transverses abdominis plane - a systematic review. Braz J Anesthesiol. 2015;65 (4):255-80.
- Fields AC, Gonzalez DO, Chin EH et al. Laparoscopic- Assisted Transversus Abdominis Plane Block for Postoperative Pain Control in Laparoscopic Ventral Hernia Repair: A Randomized Controlled Trial. J Am coll Surg. 2015; 221 (2):462-9.
- GünerCan M, Go z R, Berber İ et al. Ultrasound/Laparoscopic Camera-Guided Transversus Abdominis Plane Block for Renal Transplant Donors: A Randomized Controlled Trial. Ann Transplant. 2015; 23 (20):418-23.
- Sinha S, Palta S, Saroa R et al. Comparison of ultrasound-guided transverses abdominis plane block with bupivacaine and ropivacaine as adjuncts for postoperative analgesia in laparoscopic cholecystectomies. Indian J Anaesth 2016;60:264-9.
- Manjaree Mishra, Shashi Prakash Mishra. Transversus Abdominis Plane block: The new horizon for postoperative analgesia for abdominal surgeries. Egyptian journal of Anaesthesia 2016;32(2):243-7.
How to Cite This Article
Vancouver
Sharma N, Mehta N, Sharma S. An evaluation of (0.25%) Bupivacaine Vs (0.5%) Ropivacaine for postoperative analgesia using ultrasound guidedtransversus abdominis plane block for abdominal surgeries: A comparative study [Internet]. Indian J Clin Anaesth. 2016 [cited 2025 Oct 17];3(4):635-639. Available from: https://doi.org/
APA
Sharma, N., Mehta, N., Sharma, S. (2016). An evaluation of (0.25%) Bupivacaine Vs (0.5%) Ropivacaine for postoperative analgesia using ultrasound guidedtransversus abdominis plane block for abdominal surgeries: A comparative study. Indian J Clin Anaesth, 3(4), 635-639. https://doi.org/
MLA
Sharma, Neha, Mehta, Nandita, Sharma, Shikha. "An evaluation of (0.25%) Bupivacaine Vs (0.5%) Ropivacaine for postoperative analgesia using ultrasound guidedtransversus abdominis plane block for abdominal surgeries: A comparative study." Indian J Clin Anaesth, vol. 3, no. 4, 2016, pp. 635-639. https://doi.org/
Chicago
Sharma, N., Mehta, N., Sharma, S.. "An evaluation of (0.25%) Bupivacaine Vs (0.5%) Ropivacaine for postoperative analgesia using ultrasound guidedtransversus abdominis plane block for abdominal surgeries: A comparative study." Indian J Clin Anaesth 3, no. 4 (2016): 635-639. https://doi.org/