Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr-Jun;7(2):65-8.
doi: 10.4103/0976-7800.185327.

Postoperative pain relief following hysterectomy: A randomized controlled trial

K P Raghvendra  1 , Deepak Thapa  1 , Sukanya Mitra  1 , Vanita Ahuja  1 , Satinder Gombar  1 , Anju Huria  2
Affiliations

Postoperative pain relief following hysterectomy: A randomized controlled trial

K P Raghvendra et al. J Midlife Health. 2016 Apr-Jun.

Abstract

Background: Women experience moderate to severe postoperative pain following total abdominal hysterectomy (TAH). The transversus abdominis plane (TAP) block is a new modality for providing postoperative pain relief in these patients.

Materials and methods: The present study was a single center, prospective randomized trial. After the Institutional Ethics Committee approval and informed consent, patients were randomized to either epidural group: Epidural block placement + general anesthesia (GA) or TAP group: Single shot TAP block + GA. Patients in both the groups received standard general anesthetic technique and intravenous tramadol patient-controlled analgesia in the postoperative period. Patients were monitored for tramadol consumption, visual analog scale (VAS) both at rest and on coughing, hemodynamics, and side effects at 0, 2, 4, 6, 8, 12, and 24 h postoperatively.

Results: The total consumption of tramadol in 24 h was greater in TAP group as compared to epidural group (68.8 [25.5] vs. 5.3 [11.6] mg, P < 0.001). The VAS scores at rest and on coughing were higher in TAP group as compared to the epidural group at 6, 8, 12, and 24 h postoperatively (P < 0.05). None of the patients in either group had any adverse effects.

Conclusion: Epidural analgesia provided greater tramadol-sparing effect with superior analgesia postoperatively as compared to TAP block in patients up to 24 h following TAH.

Keywords: Epidural block; postoperative pain relief; total abdominal hysterectomy; transversus abdominis plane block.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Consort diagram
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Azari L, Santoso JT, Osborne SE. Optimal pain management in total abdominal hysterectomy. Obstet Gynecol Surv. 2013;68:215–27. - PubMed
    1. Carney J, McDonnell JG, Ochana A, Bhinder R, Laffey JG. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg. 2008;107:2056–60. - PubMed
    1. Brull R, Macfarlane AJ, Chan VW. Spinal, epidural, and caudal anesthesia. Miller’s Anaesthesia. In: Miller RD, editor. 8th ed. Vol. 1. Philadelphia: Churchill Livingstone; 2015. pp. 1684–720.
    1. Bhattacharjee S, Ray M, Ghose T, Maitra S, Layek A. Analgesic efficacy of transversus abdominis plane block in providing effective perioperative analgesia in patients undergoing total abdominal hysterectomy: A randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2014;30:391–6. - PMC - PubMed
    1. Petersen PL, Mathiesen O, Torup H, Dahl JB. The transversus abdominis plane block: A valuable option for postoperative analgesia. A topical review? Acta Anaesthesiol Scand. 2010;54:529–35. - PubMed