Efficacy of Ultrasound-Guided Continuous Transversus Abdominis Plane Block versus Continuous Epidural Analgesia in Postoperative Pain Management Following Abdominal Surgery

Postoperative pain increases morbidity and acts as a hindrance to early recovery. In this study, we have compared Epidural analgesia and Transversus abdominis plane block (TAPB) Primary Objective Comparison of postoperative opioid requirement in first 24 hours following surgery in patients given continuous TAPB and continuous epidural analgesia measured as the proportion of patients who used more than 2?g/kg of fentanyl during the first 24 h on arrival at the recovery ward METHODS 92 patients with ASA status I and II, aged 18? 68 years, posted for abdominal surgeries at Medical College, Trivandrum were enrolled in this observational study by consecutive sampling. After routine pre-anaesthetic check-up, all patients had General Anaesthesia standardized with Propofol, Isoflurane, Fentanyl titrated to effect and Vecuronium. Preoperatively the EA patients had an epidural catheter placed at appropriate level and at the end of the procedure, a bolus of 6 to 8 ml of Bupivacaine 0.25% + 50?g fentanyl. The data was entered into a master chart using Microsoft excel and analysed using statistical software CONCLUSION From our study, we can conclude that continuous epidural infusion provides better postoperative analgesia when compared to continuous TAP infusion. Fentanyl consumption was significantly lower in the epidural group compared to the TAP group. Epidural analgesia also provided lesser postoperative pain scores at rest and movement.