A clinical study to assess the adverse effects and blood pressure fluctuations post usg guided tap block with 0.25% bupivacaine and 0.25% bupivacaine with 50µG fentanyl following total abdominal hysterectomy under general anesthesia

Background: Total abdominal hysterectomy (TAH) is a commonly performed major abdominal surgical procedure in females of perimenopausal age group that results in substantial postoperative pain and discomfort. Postoperative pain requiring bed rest and persistent gastrointestinal dysfunction are key factors that force the patients to stay in the hospital. The transversus abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents. Objective: To Assess the adverse effects and Blood pressure fluctuations post USG guided TAP block with 0.25% bupivacaine and 0.25% bupivacaine with 50µg fentanyl following total abdominal hysterectomy under general anesthesia Methods: This clinical study is conducted in the Department of Anaesthesiology and Critical care, Pt. J. N. M. Medical College and Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur (C.G.) from 01/04/2014 to 22/09/2015. Results: Nausea was recorded in 11 and 15 patients in group B and F respectively. Vomiting occurred in 2 patients in group B. No other side effects were recorded in any group. The comparison of side effects between the two groups was not statistically significant. (p > 0.05). The mean (± sd) values of heart rate (heart beat per minute) at different time intervals. No significant change was observed in HR in either group at any time interval (>0.05). No significant changes were observed in SBP & DBP in either group at any time interval (>0.05). Conclusion: USG guided TAP block with fentanyl and bupivacaine improves analgesia and prolonges the time to first analgesic requirements and decreases the need for postoperative analgesics in patients undergoing total abdominal hysterectomy with minimal side effects only nausea and vomiting is recorded. No significant changes were observed in HR, SBP & DBP in either group at any time interval.