Publication:
Postoperative Analgesic Effect of Morphine Added to Bupivacaine for Transversus Abdominis Plane (TAP) Block in Appendectomy

creativeworkseries.issn1812-2027
dc.contributor.authorGhimire, A
dc.contributor.authorBhattarai, B
dc.contributor.authorPrasad, JN
dc.contributor.authorSubedi, A
dc.contributor.authorThapa, P
dc.contributor.authorLimbu, PM
dc.contributor.authorAdhikari, S
dc.date.accessioned2025-10-29T05:54:27Z
dc.date.available2025-10-29T05:54:27Z
dc.date.issued2017
dc.descriptionGhimire A,1 Bhattarai B,1 Prasad JN,1 Subedi A,1 Thapa P,1 Limbu PM,1 Adhikari S2 1Department of Anaesthesiology and Critical Care 2Department of General Surgery B P Koirala Institute of Health Sciences, Dharan, Nepal
dc.description.abstractABSTRACT Background Transversus abdominis plane (TAP) block with local anaesthetics produces effective pain relief following lower abdominal surgeries. Although opioids have been found to have effects through peripheral receptors also, reports on their effect when used as additive to local anaesthetics for TAP block are lacking. Objective To assess the analgesic effect of peripherally administered morphine with bupivacaine for ipsilateral TAP block in patients undergoing emergency appendectomy under general anaesthesia. Method Sixty patients undergoing appendectomy were randomized to undergo ipsilateral TAP with 20 ml of 0.5% bupivacaine plus 2 ml of NS (total 22 ml) and 2 ml of intravenous (IV) saline (Group TB) or with 20ml of 0.5% bupivacaine plus 2 mg (2 ml) of morphine (total 22 ml) and 2 ml of NS IV (Group TBM) or with 20 ml of 0.5% bupivacaine plus 2 ml of NS (total 22 ml) and 2 mg (2 ml) IV morphine (Group TB-IVM). Pain severity was measured using Visual Analogue Scale (VAS) preoperatively (Baseline) and at 30 min, 6h, 12 h and 24 h postoperatively. Inj. tramadol 50 mg IV was used as rescue analgesic when postoperative VAS was 4 or more. The duration of analgesia (time to first analgesic) and the postoperative 24 h tramadol requirement was recorded. Result The mean duration of analgesia in Group TBM was significantly longer (801.50 ± 74.92 min, p=0.002) than in Group TB (720.00 ± 42.17 min) and Group TB-IVM (712.70 ± 40.94 min). The mean postoperative 24 h tramadol requirement was also less in Group TBM (69.23 ± 25.31mg) than in Groups TB (100.00 ± 38.34 mg) and TB-IVM (95.00 ± 39.40 mg) but did not reach the level of statistical significance (p=0.057). Significantly less ondansetron was required in Group TBM (3.80 ± 2.04 mg) than in Group TB (6.80 ± 2.93 mg) and TB-IVM (6.00 ± 2.75 mg) (p=0.002). Conclusion Morphine added to bupivacaine effectively prolongs the analgesic duration of TAP block in appendectomy. KEY WORDS Morphine, postoperative analgesia, transversus abdominis plane block, USG guided
dc.identifier.urihttps://hdl.handle.net/20.500.14572/2868
dc.language.isoen_US
dc.publisherKathmandu University
dc.subjectMorphine
dc.subjectpostoperative analgesia
dc.subjecttransversus abdominis plane block
dc.subjectUSG guided
dc.titlePostoperative Analgesic Effect of Morphine Added to Bupivacaine for Transversus Abdominis Plane (TAP) Block in Appendectomy
dc.typeArticle
dspace.entity.typePublication
local.article.typeOriginal Article
oaire.citation.endPage141
oaire.citation.startPage137
relation.isJournalIssueOfPublication1b26738f-f35e-4559-878b-77edb14570b6
relation.isJournalIssueOfPublication.latestForDiscovery1b26738f-f35e-4559-878b-77edb14570b6
relation.isJournalOfPublicationa782b7ff-cf89-4178-ad1c-11ed89cfe1bd

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