Management of post-operative pain after gyneco-obstetrical surgery: practice of transversus abdominis plane bloc (tap block) echoguide at the Ignace Deen national hospital

Abstract

Introduction: Gyneco-obstetrical surgery exposes patients to severe postoperative pain and requires proper management. TAP block is gaining more and more interest in analgesic protocols after gyneco-obstetric surgery. The objective of this study was to describe the practice of ultrasound-guided TAP block in the management of postoperative pain after gyneco-obstetric surgery. 
Methods: We conducted a prospective descriptive study in the Department of Gynecology-Obstetrics of the Hôpital National Ignace Deen (HNID) over a period of three (03) months from February 1 to April 31, 2020. Our variables were socio-demographic, clinical, technical and evolutive.
Results: In total, we collected 95 patients. These patients had a mean age of 30 years ± 9.5. The ASA I class was the most represented with 76% of the cases and caesarean section was the most performed procedure. Concerning the evaluation of the pain score by the simple verbal scale (EVS) postoperatively at rest, the mean of the EVS scores at H6 was 0.17±0.38; at H12 was 1.15±0.62;at H24 was 0.84±0.51; at H36 was 0.45±0.52 and at H48 was 0.09±0.29. At mobilization, the mean pain scores were 0.77±0.51 at H6, at H12 1.89±0.61; at H24 1.53±0.56; at H36 1±0.29 and at H48 0.82±0.44. The majority of our patients (66.3%) had a mobilization time of less than 24 hours. The average length of stay was 3.1±1.3 days and 82% of the patients were satisfied with the management of their pain by ultrasound-guided TAP block.   
Conclusion: Our study showed that ultrasound-guided TAP block is effective for the management of OPD. Its integration in the context of multimodal analgesia would improve the management of OPD after gyneco obstetric surgery.