• Experience with TAP-block or analgesia after total abdominal hysterectomy
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Experience with TAP-block or analgesia after total abdominal hysterectomy

OF WOMAN. 2016.6(112):118–120 

Experience with TAP-block or analgesia after total abdominal hysterectomy 

Rybin M. S.

Kyiv city center of reproductive and perinatal medicine

The objective: to show the benefits of the treatment of pain in patients after abdominal gynecological operations through the use of TAP-block as a variant of post-operative analgesia.

Patients and methods. The study involved 104 women who have total abdominal hysterectomy was performed. Group I (control) included 36 women treated for pain dexketoprofen at the dose of 50 mg every 8 o’clock and morphine hydrochloride at a dose of 10 mg as required, in II group – 34 women, which was supplemented by standard analgesia extended TAP block, III group – 34 patients, analgesic EDA in conjunction with a conventional method.

Results. In the study groups, which used techniques of regional analgesia, there was a high efficiency of analgesia in the postoperative period as compared to the systemic administration of narcotic analgesics. The most severe pain was observed in the control group. Patients treated with extended-TAP block and EDA showed a significant decrease in daily requirement of morphine (TAP block group 18.75±6.4 mg/day, EDA 16.4±5.2 mg/day. A control group of 36.25±5.2 mg/day, p<0.05). The median time to the first request for morphine was significantly greater in patients treated with extended-TAP block (TAP block group – 5.26 ±0.03 hours, EDA 6,34±0,02 hours, the control group 0.26±0.01 hr., p<0.05). Patients of the control group displays sedation narcotic analgesics were more pronounced than in other groups of patients during the first two hours of observation. The frequency of the incidence of complications such as postoperative nausea and vomiting, had a relationship with the amount and the time of administration of morphine.

Conclusions. The use of TAP block is a promising component of the mixed mode of analgesia after abdominal hysterectomy in the postoperative period, significantly increases the efficiency of post-operative analgesia, improves patient comfort, reduce the need for opioids, which reduces the occurrence of complications.

Key words: abdominal hysterectomy, postoperative pain, analgesia, TAP block.


1. Doğanay M et al. 2011. Abdominal, vaginal and total laparoscopi chysterectomy: perioperative morbidity. Archives of Gynecology and Obstetrics 284(2):385-9. http://dx.doi.org/10.1007/s00404-010-1678-8; PMid:20844884

2. Walsh CA et al. 2009. Total abdominal hysterectomy versus total laparoscopic hysterectomy for benign disease: a meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology 144(1):3-7. http://dx.doi.org/10.1016/j.ejogrb.2009.01.003; PMid:19324491

3. Ovechkin АM, Romanova TL. 2006. Postoperative analgesia optimization approaches in terms of evidence-based medicine. Russian Medical Journal 12:865-71.

4. Bonnet F, Berger J, Aveline C. 2009. Transversus abdominis plane block: what is its role in postoperative analgesia? British journal of anaesthesia 103(4):468-70. http://dx.doi.org/10.1093/bja/aep243; PMid:19749115

5. Jankovic ZB, Pollard SG, Nachiappan MM. 2009. Continuous transversus abdominis plane block for renal transplant recipients. Anesthesia & Analgesia 109(5):1710-1. http://dx.doi.org/10.1213/ANE.0b013e3181ba75d1; PMid:19843821