Comparing the efficacy of standard spinal anesthesia and transversus abdominis plane block with Ropivacaine 0.5% on relieving the postoperative pain after laparoscopic gynecologic surgery

Determination of the effect of transversus abdominis plane block with Ropivacaine 0.5% in relieving postoperative pain after laparoscopic gynecologic surgery

This study is a clinical trial with a control group, parallel-group design, double-blinded and randomized.

The population of the study included 200 women candidates for elective laparoscopic gynecologic surgery who referred to Alzahra hospital in Isfahan during 2016-2017. The intervention is done at the operating room. Severity of pain and nausea and vomiting is recorded at the time of recovery, at 30 minutes, 2, 4, 6, 12, and 48 hours after surgery. For evaluating the severity of pain, visual analogue scale (VAS), based on a score of 0 (painless) to 10 (most pain) was used. Peptidine and diclofenac suppository were used if necessary at the time of no pain reduction (pain more than 3). Nausea and vomiting were also determined based on a score of 0 to 3 (0 means non-existence, 1 means mild, 2 means moderate and 3 means severe).

Inclusion criteria : Candidate for laparoscopic gynecologic surgeries (such as ovarian cystectomy and hysterectomy); willingness to participate in the study. Exclusion criteria: Having a history of allergy to the agents used in the study; suffering from acute and/or chronic preoperative pains.

Intervention group: In this group, in addition to standard spinal anesthesia, an anesthetic drug Ropivacaine (Naropin,0.5%) was injected at a dose of 0.5 mg / kg between transverse abdominal muscle and internal oblique muscle facia. Control group: Patients in this group just received standard spinal anesthesia.

severity of pain; severity of nausea and vomiting

200 eligible patients were recruited to the study through easy non-randomization method. Then we randomly assigned patients to a treatment or control groups through simple randomization method using random allocation software.

Patients were randomly assigned to one of the two groups before surgery. Then their group was recorded by the ward secretary and the list was given to the anesthetist. The patients were kept unaware from the groups they were allocated. Then the patients in the intervention group underwent transversus abdominis plane block by an anesthetist. After the surgery, a student who was unaware of the allocation, completed the post-operative pain and other symptoms cheklists and delivered to the secretary.