MULTIMODAL TAP BLOCK WITH KETOPROFEN VERSUS EPIDURAL ANALGESIA AFTER LAPAROSCOPIC AND OPEN ABDOMINAL SURGERY: A...

Effective analgesia is imperative to cover post-operative pain after laparoscopic surgery and laparotomy. While systemic opioid drugs are often used for this purpose, the decrease in opioid administration is highly desirable and the multimodal forms of post-operative anesthesia are preferable. The present study aimed to assess the effectiveness of the TAP block either alone or in combination with systemic NSAID administration compared to epidural anesthesia following laparoscopic surgery and laparotomy.

180 patients subjected to laparoscopic surgery or laparotomy were divided into three equal (n= 60) groups. One group received the bipolar TAP block in the early postoperative period (during the first 24 hours). In addition, the patients of this group also received the intravenous administration of ketonal. In the second group, only an ultrasound-guided transverse abdominal block was used. The third group received epidural anesthesia.

We found no significant differences in pain assessment according to the visual analog scale, Likert scale, hemodynamic criteria, and SpO2 between the first and third experimental groups. In addition, there were no significant differences in the incidence of the post-operative side effects and the time of transition of the patient to ambulatory care between the first and third experimental groups.

Based on the above results, we suggest that multimodal analgesia in the form of bipolar TAP block in conjunction with intravenous administration of ketonal provides adequate anesthesia in the postoperative period, comparable to epidural anesthesia. In addition, the proposed method of TAP blockade reduces the number of side effects and hypotension in the postoperative period.