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Management of Post-Operative Pain after Gyneco-Obstetrical Surgery: Practice of Transversus Abdominis Plane Bloc (tap block) Echoguide at the Ignace Deen National Hospital

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Open Journal of Anesthesiology 2021年第10期11卷 316-324页

作者： Donamou Joseph Bangoura Almamy Touré Abdoulaye Camara Amadou Yalla Traoré Abdourahamane Dine Camara M’Mah Lamine Camara M’Mah Lamine Dramé Boubacar Atigou Camara Mariama Mohamed Orou Yerima Therese Touré Aboubacar Anesthesia-Intensive Care Unit Donka National Hospital Conakry Guinea Anesthesia-Intensive Care Unit National Ignace Deen Hospital Conakry Guinea Medico-Surgical Emergency Department Donka National Hospital Conakry Guinea General and Visceral Surgery Department Ignace Deen National Hospital Conakry Guinea

Objectives: To describe the practice of ultrasound-guided tap in the management of postoperative pain after gyneco-obstetric surgery. Methods: This was a descriptive prospective study carried out at the Gynecology-Obstetrics department of the Ignace Deen National Hospital over a period of three (03) months from February 01, 2020 to April 31, 2020. Results: In total, we collected 95 patients. These patients had a mean age of 30 ± 9.5 years. The ASA I class was the most represented with 76% of the cases and the cesarean was the most performed intervention. Regarding the assessment of the pain score by the simple verbal scale (SVE) postoperatively at rest, the mean SLE scores at H6 were 0.17 ± 0.38;at H12 of 1.15 ± 0.62;at H24 of 0.84 ± 0.51;at H36 0.45 ± 0.52 and at H48 0.09 ± 0.29. On mobilization, the mean pain scores were 0.77 ± 0.51 at H6, at H12 1.89 ± 0.61;at H24 of 1.53 ± 0.56;at H36 of 1 ± 0.29 and at H48 of 0.82 ± 0.44. The majority of our patients (66.3%) had a mobilization time of less than 24 hours. The mean length of stay was 3.1 ± 1.3 days and most patients (82%) were satisfied with the management of their pain by ultrasound-guided tap block. Conclusion: Ultrasound-guided tap is an effective technique for the management of postoperative pain in gyneco-obstetrics surgery. Its integration in a context of multimodal analgesia could improve the management of postoperative pain in gynecological obstetrics.

关键词： Postoperative Pain tap block Ultrasound Guidance Gyneco-Obstetrics

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Intraoperative Hemodynamic and Analgesic Effects of Pre-Incisional Transversus Abdominis Plane block during Total Abdominal Hysterectomy

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Open Journal of Anesthesiology 2017年第12期7卷 393-399页

作者： Owono Etoundi Paul Jemea Bonaventure Bengono Bengono Roddy Tochie Joel Afane Ela Anatole Ze Minkande Jacqueline Department of Surgery and Specialties/Anesthesiology Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundeCameroon

Background: The efficacy of transversus abdominis plane (tap) block has been demonstrated in postoperative analgesia, but few studies have evaluated its intraoperative effects. We aimed to describe the intraoperative hemodynamic and analgesic effects of pre-incisional tap block in patients undergoing total abdominal hysterectomy. Methods: Seventy women proposed for total abdominal hysterectomy indicated for uterine fibroids, classified ASA I and II were randomized in a double-blinded model to Group A (n = 35) receiving bilateral ultrasound-guided tap block with ropivacaine and Group B (n = 35) receiving bilateral ultrasound-guided tap block with normal saline, followed by general anesthesia. The variations of the heart rate (HR) and mean arterial blood pressure (MABP) and intraoperative fentanyl consumption were studied. Results: At the arrival in the operating room, there was no significant difference in heart rate and mean arterial pressure noted in both groups. (HR: 85.38 ± 8.44 pulsations/min versus 86.30 ± 10.05 pulsations/min, p = 0.621;MABP: 94.97 ± 13.46 mmHg versus 96.36 ± 12.41 mmHg, p = 0.533). Before surgical incision, no statistically significant difference was detected between the two groups regarding the heart rate and the mean arterial blood pressure. After surgical incision, both the heart rate and mean arterial blood pressure were significantly higher in the Group B. There was a significant decrease in intraoperative fentanyl requirements in the Group A compared to the Group B (293.58 ± 60.59 mcg versus 449.44 ± 71.31 mcg, p Conclusion: Pre-incisional tap block attenuates hemodynamic responses to surgical stress and decreases intraoperative fentanyl requirements in patients undergoing total abdominal hysterectomy.

关键词： tap block Hemodynamic Effects Intraoperative Analgesia Hysterectomy

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