Subcostal TAP Block Versus Lateral TAP Block for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy

Background: Patients experience severe postoperative pain after total abdominal hysterectomy surgeries. Effective pain management reduces the incidence of postoperative cardiac and pulmonary complications, decreases risk of postoperative deep venous thrombosis through early mobilization, provides patient satisfaction and reduces cost of hospital stay. Multiple analgesic strategies have been used to reduce postoperative pain following abdominal surgeries. Studies suggest that abdominal wall blocks are more effective modalities to achieve pain relief and enhance postoperative rehabilitation than systemic analgesia. The aim of this study is to compare the effectiveness of subcostal versus lateral TAP blocks for post-operative pain management after total abdominal hysterectomy surgery. Results: The results showed that postoperative bilateral subcostal TAP block in group (A) was associated with significant increase in heart rate, mean arterial blood pressure, pain scores and pethidine requirements compared to bilateral lateral TAP block in group (B) which provided more effective analgesia than subcostal approach. Conclusions: In patients undergoing total abdominal hysterectomy, postoperative analgesia of lateral TAP block was more effective than that of subcostal TAP block regarding hemodynamic changes, pain scores, doses of pethidine required for pain relief and postoperative mobilization.