Transversus abdominis plane block: The analgesic efficacy of a new block catheter insertion method

Background: Local anesthetic (LA) administration via a correctly placed block catheter could help optimum deposition in the transversus abdominis plane (TAP). The aim of the study is to assess the postoperative analgesic efficacy of TAP block achieved by initially injecting the LA through a catheter placed by ultrasound-guided Seldinger catheter insertion approach (USCIA). Methods: Fifty patients scheduled for open inguinal hernia repair were randomized into two groups. Group USCIA: Patients received USCIA-TAP block. Group control: Patients did not receive TAP block. All patients received patient-controlled intravenous morphine postoperatively. The analgesic efficacy of USCIA-TAP block was assessed measuring the total amount of postoperative morphine requirements over the first 48 h postoperatively. Pain scores and level of patient satisfaction with pain relief after surgery were noted. Results: The mean cumulative morphine requirement over the first 48 postoperative hours was significantly lower in USCIA group in comparison with the Control group (18.1 ± 4.1 vs. 57.9 ± 5.3 mg). The success rate of USCIA-TAP block catheter placement was 88%. The pain score of USCIA group was significantly lower at 3, 6, 12, and 24 postoperative hours compared with the Control group. The USCIA group had a significantly higher rate of satisfaction with regard to pain control in comparison with the Control group at the 12th and 24th postoperative hours (9 {8–10} vs. 6 {5–7} and 9 {8–10} vs. 7 {6–8}, respectively). Conclusion: The use of a single dose of USCIA-TAP block reduced the total amount of morphine requirement over the first 48 postoperative hours for patients undergoing abdominal surgery