Aims and Objectives: Transversus abdominis plane block is a regional anaesthesia technique. It provides analgesia after abdominal surgery particularly where parietal wall pain forms major component of pain. It allows sensory blockade of lower abdominal wall skin and muscles via local anaesthetic deposition above transverses abdominus muscle. We evaluated the efficacy of TAP block with Ropivacaine and Bupivacaine for post operative analgesia in abdominal surgery, a double blind, prospective randomized controlled trial.

Method: 50 patients undergoing elective abdominal surgeries under general anaesthesia were randomized to undergo Tap block with Ropivacaine (n=25) or Bupivacaine (n=25).Tap block was performed at the end of surgery using 20ml of 0.5% Ropivacaine or 0.25% Bupivacaine each side. Each patient was assessed postoperatively by a blinded observer at 30mins, 1, 3, 6, 12 & 24 hrs in ward.

Result: The results in both groups were comparable clinically as well as statistically.

Conclusion: we conclude that 0.5% Ropivacaine provided longer duration of analgesia than 0.25% Bupivacaine when used in TAP block for patients undergoing abdominal surgery. Both drugs have a good safety profile. Both drugs show outstanding clinical utility in terms of reliability and effective analgesia.
Keywords: TAPB, Bupivacaine,  Ropivacaine,  post operative analgesia, general anaesthesia,

1. Peripheral I, Be a, Know B. Anatomy and Physiology. Pain. 2005;1–4.
2. Aveline C, Le Hetet H, Le Roux A, Vautier P, Cognet F, Vinet E, et al. Comparison between ultrasound-guided transversus abdominis plane and conventional ilioinguinal/ iliohypogastric nerve blocks for day-case open inguinal hernia repair. Br J Anaesth. 2011;106(3):380–6.
3. Clinical Anesthesiology [Internet]. 2014.
4. Kuppuvelumani P, Jaradi H, Delilkan A. Abdominal Nerve Blockade For Postoperative Analgesia After Caesarean Section. Asia Ocean J Obs Gynaecol 1993;19.
5. Niraj G, Searle A, Mathews M, Misra V, Baban M, Kiani S, et al. Analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing open appendicectomy. Br J Anaesth. 2009;103(4):601–5.
6. McDonnell JG, Curley G, Carney J, Benton A, Costello J, Maharaj CH, et al. The analgesic efficacy of transversus abdominis plane block after cesarean delivery: A randomized controlled trial. Anesth Analg. 2008;106(1):186–91.
7. Louis S. , N. M. 2007;35(4).
8. Tripathi KD. chapter 26 : Local anaesthetics. 6/e. New Delhi: Jaypee brothers; 2008. 339-349 p.
9. Lee A, Fagan D, Lamont M, Tucker GT, Halldin M, Scott DB. Disposition Kinetics of Ropivacaine in Humans [Internet]. Vol. 69, Anesthesia & Analgesia. 1989.
10. Joshi, P. G, Viscusi, R. E, Gan, J. T, et al . Effectivetreatment of laparoscopic cholecystectomy pain with intravenous followed by oral COX-2 specific inhibitor Vol. 98, Anesthesia & Analgesia. 2004.p.336–42.
11. Boccara G, Chaumeron A, Pouzeratte Y, Mann C. The preoperative administration of ketoprofen improves analgesia after laparoscopic cholecystectomy in comparison with propacetamol or postoperative ketoprofen. BJA Br J Anaesth 2005; 94(3):347.
12. Fujii Y, Toyooka H, Tanaka H. Efficacy of thoracic epidural analgesia following laparoscopic cholecystectomy. Eur J Anaesthesiol [Internet]. 1998 May [cited 2017 Jun 8];15(3):342–4.
13. Michaloliakou C, Chung F, Sharma S. Preoperative multimodal analgesia facilitates recovery after ambulatory laparoscopic cholecystectomy. Vol. 82, Anesthesia and analgesia. 1996. p. 44–51.
14. De Oliveira GS, Fitzgerald PC, Marcus RJ, Ahmad S, McCarthy RJ. A dose-ranging study of the effect of transversus abdominis block on postoperative quality of recovery and analgesia after outpatient laparoscopy. Anesth Analg.2011;113(5):1218–25.
15. Bharti N, Kumar P, Bala I, Gupta V. The efficacy of a novel approach to transversus abdominis plane block for postoperative analgesia after colorectal surgery. Anesth Analg. 2011;112(6):1504–8.
16. Young MJ, Gorlin AW, Modest VE, Quraishi SA Clinical implications of the transversus abdominis plane block in adults. Anesthesiol Res Pract. 2012;2012.
17. Fuladi N, Deshmukh S, Bhure A. Comparative Study of Bupivacaine 0.25% Versus Ropivacaine 0.5% in Transversus Abdominis Plane Block for Postoperative Analgesia in Lower Abdominal Surgeries : a Randomised Controlled Trial. J Evol Med Dent Sci [Internet]. 2014;3(17):4569–76. Available from: http://www.jemds.com/data_pdf/neha fuladi.pdf
18. Sharma N, Mehta N, Sharma S. An evaluation of (0.25%) Bupivacaine Vs (0.5%) Ropivacaine for postoperative analgesia using ultrasound guidedtransversus abdominis plane block for abdominal surgeries: A comparative study. Indian J Clin Anaesth. 2016;3(4):635–9.
19. Patel D, Patel B, Patel H, Shah D, Vachhrajani P.Transversus Abdominis Plane Block for Post Operative Analgesia in Lower Abdominal Surgery : A Comparison of Bupivacaine and Ropivacain. 2016;5 (12):446–50.
20. El-Dawlatly AA, Turkistani A, Kettner SC, Machata AM, Delvi MB, Thallaj A, et al. Ultrasound-guided transversus abdominis plane block:description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy. Br J Anaesth [Internet]. 2009;102.

Preethi Vaddi

Postgraduate, Department of Anaesthesiology, GEMS