Combined subcostal and posterior transversus abdominis plane block for postoperative pain relief after abdominoplasty : a randomized clinical trial

الملخص EN

Background: Abdominoplasty is a common esthetic surgery.

For adequate pain management during the postoperative period, transversus abdominis plane block (TAPB) is a therapeutic complement for analgesia for postoperative pain following abdominal surgery.

Aim: To compare the outcomes of TAPB and systemic opioids in patients undergoing abdominoplasty.

Methods: Fifty-eight patients undergoing abdominoplasty were randomly assigned to two groups: Combined subcostal and posterior TAPB group (BG, n=29) and Control group (CG, n=29).

The standard postoperative analgesic regimen for both groups consisted of IV Paracetamol 1 g every 6 h.

The visual analog scale (VAS) scores for pain were recorded postoperatively, and once the patient had a VAS ≥4, IV pethidine was administered.

The primary outcome was pethidine consumption in the first 72 h postoperatively; the secondary outcomes included VAS scores at rest and during movement in the first 72 h postoperatively, time to first ambulation, and time to first incentive spirometer at 900 mL/min.

Results: Pethidine consumption in the first 72 h was 208.62±85.64 in the CG group and 20.69±25.06 in BG (p<0.05).

VAS was lower in BG during the first 72 h both at rest and during movement (p<0.05).

Time to first ambulation was 12.41±5.04 h in the CG group and 4.62±1.08 h in BG (p<0.05), time to first incentive spirometer at 900 mL/min was 11.45±5.05 h in CG and 4.27±1.09 h in BG (p<0.05).

Conclusion: Combined subcostal and posterior TAPB offers a longer postoperative analgesic effect and reduced postoperative opioid requirements with fewer postoperative complications.