Comparison Between Tranversus Abdominis Plane (TAP) Block With Only Bupivacaine and TAP Block With Bupivacaine Plus Ketamine in Reducing Postoperative Pain After Total Abdominal Hystrectomy

Transversus Abdominis Plane Block : A Comparative Study Between Bupivacaine vs Bupivacaine With Ketamine in Total Abdominal Hystrectomy

The goal of this study is to know how effectively TAP block can reduce postoperative pain in total abdominal hystrectomy patients when given ketamine in addition to bupivacaine in TAP block and to compare it with the conventional TAP block with bupivacaine only. The main question it aims to answer is:

Does intervention with ketamine in TAP block lowers the postoperative pain measured via visual analog scale and decreases the need for rescue analgesia?

Patients will be assessed for pain in PACU( post anesthesia care unit), 6 hours, 12 hours and 24 hours postoperatively. Time of rescue analgesia will also be noted if given.

This is a prospective, randomized, double blind control trial.Patients will be randomly divided into 2 groups; group A and group B with 15 patients in each group. Group A will recive TAP block with 20ml solution of 0.25% bupivacaine on each side of abdomen while group B will recieve 50mg ketamine in addtion to 20ml of 0.25% bupivacaine.The drugs will be prepared by the second anesthesiologist who will not be part of data collection and analysis.Post operative pain will be assessed using VAS score in PACU, after 6 , 12 and 24hours post total abdominal hystrectomy. Inj. tramadol 50mg will be used as rescue analgesia.In addition to inj. pracetamol 1g 8 hourly and inj. ketorolac 30mg 12 hourly, time for administration of rescue analgesia will be noted.

Inclusion Criteria:

• Aged between 25 to 60 years.
• ASA grade I & II.
• Undergoing total abdominal hysterectomy.

Exclusion Criteria:

• BMI >35kg/m2.
• Patient refusal for participation.
• Patients with coagulation disorders.
• Patents with history of allergy and hypersensitivity to local anesthetic.
• Patient having infection at the injection site.
• Alcohol or drug abuse.
• Cognitive or mental disorder.