Background: It has long been known that local anesthetic methods, especially abdominal wall field blocks, are a useful analgesic approach that can be utilized to combat postoperative wound pain.
Objective: This study aimed to compare the efficacy and safety of surgeon-administered transversus abdominis plane(TAP) block versus TAP block provided by an anesthesiologist regarding pain relief after abdominal gynecological surgery.
Methods: Between March 2023 and June 2024, 88 women undergoing abdominal gynecological surgery at the Obstetrics and Gynecology Departments, Menoufia University Hospital and Tala Central Hospital were included in a randomized clinical experiment. Participants were divided into three groups: 22 received a surgeon-administered (blind) TAP block, 44 received an anesthesiologist-administered ultrasound-guided TAP block, and 22 received a surgeon-administered laparoscopic-guided TAP block. A 10-point visual analogue scale (VAS) was used to measure postoperative pain scores at 2, 4, 8, 12, 18, 24, and 48 hours.
Results: The studied groups differed significantly in terms of pain VAS scores at 2,4,8,12,18, 24, and 48 hours. VAS at 2 and 18 hours were significantly higher among women who underwent blind TAP block (1.22±0.28, and 3.54±0.26 respectively) compared to those who underwent ultrasound-guided TAP block (1.01±0.15, and 3.18±0.31 respectively) and laparoscopic-guided TAP block (1.19±0.08, and 3.52±0.13 respectively). Also, VAS at 4, 24, and 48 hours were significantly higher in the laparoscopy group (1.60 ±.26, 3.71±.08, 4.53±.31 respectively) than those in U/S guided group (1.45±0.19, 3.59±0.14, 4.03±0.56 respectively). Additionally, VAS at 12 hours was significantly lower among women who underwent the U/S technique (2.46±0.25) compared to those in blind (2.66±0.18) and laparoscopy groups (2.66±0.20). However, there was no observable change in VAS at 8 hours between the groups under study.
Conclusion: In terms of postoperative pain VAS scores at 2, 4, 12, 18, 24, and 48 hours, ultrasound-guided TAP was superior to blind and laparoscopic-guided TAP blocks.