Welcome to the ePoster Viewing Panel of AICOG 2025

INTRODUCTION: Hysterectomy is the most frequently performed gynecological surgery in women Total laparoscopic hysterectomy has now become the preferred method for benign conditions. Postoperative pain after TLH is inevitable. Multimodal analgesia is recognized as a potential method in postoperative pain management TAP is potential anatomical space between transverse abdominis muscle and internal oblique muscle, the field block by TAP infiltration is called TAP block. Laparoscopic guided TAP block is a novel ?semi-blind? technique of administering the TAP block, utilizing the presence of the laparoscopic camera. AIMS AND OBJECTIVE: To determine the analgesic efficacy of transverse abdominis plane (TAP) block in laparoscopic hysterectomy and postoperative analgesic requirements. MATERIALS AND METHODS: Randomized controlled study, each group contains sample size of 50 and the study will be conducted in Department of Obstetrics & Gynecology, JSS Hospital, Mysuru Patients undergoing elective laparoscopic hysterectomy in JSS hospital, Mysuru. Patients who fulfill inclusion criteria. Randomly allocated into study and control group using SNOSE technique. STUDY GROUP CONTROL GROUP Under laparoscopic guidance 20 ml of 0.25% bupivacaine Routine analgesia as practiced in is instilled on each side at 2 sites (10 ml at each site) in our institute. subcoastal margin lateral to the lateral border of rectus (Intraoperatively muscle and midway between subcostal margin and iliac. patient receive Paracetamol 1g crest in the transverse abdominis plane IV before reversal) Postoperatively, degree of postoperative pain is assessed using Visual Analogue Score (VAS) at 1st,2nd ,4th ,6th ,12 and 24 hours. Patients with VAS >4 will receive rescue analgesia with Tramadol 50mg IV. Patients are assessed at 15 minutes and if VAS score is still >4 another dose of Tramadol 50mg IV is administered. Number of doses and time to first postoperative analgesia and requirement of opioid analgesia and frequency of side effects will be recorded. RESULT: The comparison of analgesic use between the Study and Control groups reveals significant differences in pain management efficacy. In the Study group, 66% of patients required only Diclofenac for pain relief, compared to just 16% in the Control group. Conversely, 84% of patients in the Control group needed a combination of Diclofenac, Promethazine, and Pentazocine, compared to only 34% in the Study group. CONCLUSION: Our study suggests that ultrasound-guided TAP block is an effective alternative to opioids for postoperative pain management and can therefore be considered a key element of a multimodal analgesic strategy.