Postoperative Pain Relief After Major Abdominal Gynecological Surgery

Comparison of Lumbar Epidural Analgesia, Transversus Abdominis Plane Block and Wound Infiltration for Postoperative Pain Relief in Major Abdominal Gynecological Surgery

The aim of our study was to compare the effects of Lomber Epidural Analgesia (LEA), Transversus Abdominis Plane (TAP) block and Local Anesthetic Infiltration (LAI) on postoperative morphine consumption, time to first recue analgesic request, pain and patient satisfaction scores and side effects were compared in the patients undergoing major gynecologic/oncology lower abdominal surgery.

Following faculty ethical committee approval and written informed consent, 81 patients were included in our prospective, randomized and double-blind study. Patients were divided into 3 groups: lumbar epidural block (Group E), TAP block (Group T), and wound infiltration (Group I). Demographic data, surgical characteristics, hemodynamic values, pain scores at rest and on movement, morphine consumption, additional analgesic requirement, side effects at 1, 2, 6, 12, 24, 36 and 48th hours after surgery, and patient satisfaction scores at 24 and 48th hours were recorded.

Inclusion Criteria:

• ASA I-II,
• between the age of 18-69,
• undergoing major gynecological abdominal surgery under general anesthesia

Exclusion Criteria:

• lack of patient consent
• ASA > III
• sensitivity or contraindication to study drugs
• conditions in which epidural anesthesia is contraindicated
• emergency and urgent surgery
• inability to comprehend pain scale
• any contraindication to the use of patient controlled analgesia (PCA) device.