Assessment of Continuous Epidural Analgesia Versus Continuous Surgical Transverse Abdominis Plane Block for Postoperative Analgesia in Gynecological Surgeries

Cureus. 2023 Dec 5;15(12):e49957. doi: 10.7759/cureus.49957. eCollection 2023 Dec.

Abstract

Background Surgical transverse abdominis plane (TAP) block has been studied in various surgeries. However, its role particularly in the form of continuous infusion in comparison to epidural infusion in open gynecological surgeries remains unknown. Hence, this study was taken up. Methodology Sixty patients were assigned to either of the two groups: continuous epidural (Group E) or continuous infusion in the surgical TAP (Group S). The primary outcomes were visual analog scale (VAS) pain scores and rescue analgesic requirements. Postoperative complications such as nausea/vomiting, hypotension, and bradycardia were also assessed. Results Mean pain scores were significantly lesser in Group E. However, 80% (24) of Group E and 50% (15) of Group S did not require rescue analgesia, which was not statistically significant. Adverse effects did not differ significantly between the two groups. Conclusions The efficacy of the continuous surgical TAP block is similar to a continuous epidural. Therefore, it can be considered in settings with limited resources and expertise or in cases of contraindications for an epidural.

Keywords: continuous wound infusion; epidural analgesia; open gynecological operations; postoperatve analgesia; surgical transverse abdominis plane block.