Transversus abdominis plane block versus paravertebral block for post-operative pain following open renal surgeries: A randomized clinical trial

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Abstract

Background
: Open renal surgeries are usually associated with significant pain which may increase morbidity and mortality if left untreated. Several methods are used to control pain after these surgeries including opioids, non-steroidal anti-inflammatory drugs and regional anesthetic techniques. This study aimed at comparing the thoracic paravertebral block (PVB) versus transversus abdominis plane block (TAP) in patients undergoing open renal surgeries.
Methods
: Between November 2017 and November 2018 at Assiut University Hospital, urology department 60 patients undergone open renal surgeries had been randomly allocated into two groups; group (PVB) (n = 30) who received (PVB), and group (TAP) (n = 30) who received TAP block. The regional anesthetic technique was performed in each patient after induction of general anesthesia and before performing the surgery. The primary outcome was the total analgesic consumption in the first 24 h postoperatively. Secondary outcomes included the time to the first analgesic request and the Visual Analogue Scale score (VAS) during the first 24 h postoperatively.
Results
: Total analgesic consumption during the first 24 h postoperatively was significantly lower in PVB group compared to TAP group. The VAS scores were significantly lower in PVB group compared to TAP group during the first 12 h postoperatively. However, the time to first analgesic request was non-significant between both groups.
Conclusions
: The TAP block was effective, safe and comparable to PVB for pain control following open renal surgeries. However, the paravertebral block was more potent.
Trial Registry
: ClinicalTrials.gov: NCT04697420

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