Ultrasound Guided Transverse Abdominis Plane Block for Post Operative Analgesia for Unilateral Hernioplasty

Background: Transversus abdominis plane (TAP) block with local anaesthetics produces effective pain relief following lower abdominal surgeries. Although opioids have been found to have effects through peripheral receptors, reports on their effect as additive to local anaesthetics for TAP block are lacking. Objective: To assess the analgesic effect of peripherally administered morphine with bupivacaine for ipsilateral ultrasound guided TAP block in patients undergoing unilateral hernioplasty under spinal anesthesia. Methodology and Results: After ethical committee clearance and written informed consent, Forty patients ASA I& II undergoing unilateral hernioplasty were randomized to undergo ipsilateral ultrasound guided TAP block with 20 ml of 0.5 % bupivacaine plus 2 ml of NS (Group TB) or with 20ml of 0.5 % bupivacaine plus 2 mg (2 ml) of morphine (Group TBM). The visual analog scale was compared at the time intervals 1, 2, 3, 4, 5, 6, 8, 12, 24 hrs during rest as well as movement. Inj. Tramadol 100 mg IV was used as rescue analgesic when postoperative numerical rating scale was 4 or more. The mean duration of analgesia in Group BM was longer (446 38.92 min than in Group B (281.00 42.17 min) which is statistically significant p