Postoperative analgesic efficacy of bupivacaine with hyalourindase in TAP block for lower abdominal surgeries

Document Type : Original Article

Authors

Department of, anesthesia & ICU, fuclty of Medicine, Sohag university.

Abstract

Aim : To evaluate the effect of addding hyalourindase to bupivacaine in TAP block for lower abdominal surgeries as postoperative analgesia.
Methods :  fifty patients  aged  between  20- 60 years  who were  scheduled for lower abdominal surgeries  included in the study and divided into two groups,after approval of ethical committee.This  study  conducted in Sohag university hospitals from September 2016 to March 2017.
Patients  were divided  into  two equal groups and all received spinal anesthesia  :-(Group A) 25 patients received 20 ml bupivacaine  injected in the plane between internal oplique  and transversus  abdominis musceles.(Group B) 25 patients received  20 ml bupivacaine added to 750 unit hyalourindase. Patients  were monitored for heart rate NIBP and oxygen saturation .In post –anesthesia care unit  patients were asked to assess  their level of pain based on visual analog scale (VAS) , complications also were observed .
Results :
Our study showes  that addition of hyalourindase to bupivacaine for TAP block  resulted in significant reduction in VAS pain score over the post operative 24hrs and reduction of post operative morphine requirments .

References

2372.
2-AN Rafi, Abdominal Field Block: a New Approach Via The Lumbar Triangle; Anaesthesia; 2001; 56:1024-6.
3- JG McDonnell, BD O’Donnell, D Tuite, T Farrell, C Power, The Regional Abdominal Field Infiltration Technique Computerised Tomographic and Anatomical Identification of a Novel Approach to the Transversus Abdominis Neuro-Vascular Fascial Plane; Anaesthesiology; 2004; 101: A899.
4- P Hebbard, Y Fujiwara, Y Shibata, C Royse. Ultrasound Guided Transversus Abdominis Plane Block. Anaesthesia & Intensive Care; 2007; 35(4): 616-7.
5-Marret E, Kurdi O, Zufferey P, Bonnet F: Effects of nonsteroidalantiinflammatory drugs on patient-controlled analgesia morphine sideeffects: meta-analysis of randomized controlled trials. Anesthesiology 2005,102:1249–1260.
6- Tandoc MN,Fan L,Kolesnikov  S ,Kruglov A ,Nader ND .Adjuvant dexamethasone with bupivacaine prolonges the duration of block :prospective randomized trial. J Anesth .2011;25(5):704-709 .
7- Stern R, Jedrzejas MJ. Thehyaluronidases: their genomics, structures, andmechanisms of action. Chem Rev 2006;106:818–39.
8- Roberts JE, MacLeod BA, Hollands RH. Improved peribulbar anaesthesia withalkalinization and hyaluronidase. Can  Anaesth 1993;40:835–8.
9-Atkinson WS. Use of hyaluronidase with local anaesthesia in ophthalmology;preliminary report. Arch Opthalmol 1949;42:628–33.
10- Carney J, Finnerty O, Rauf J, et al. Studies on the spread of local anaesthetic
solution in transversus abdominis plane blocks. Anaesthesia 2011;66:1023–30.
11- AN Rafi, Abdominal Field Block: a New Approach Via The Lumbar Triangle; Anaesthesia; 2001;56:1024-
Sohag Medical Journal
Volume 21, Issue 3
October 2017
Pages 295-300

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