الفهرس 
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Abstract
The ultrasound guided TAP block is a regional anaesthesia technique that provides analgesia following abdominal surgery. It became increasingly popular worldwide because of its relative simplicity and efficacy. The technique involves a single large bolus injection of local anaesthetic into the transversus abdominis plane, an anatomical space between the internal oblique and transversus abdominis muscles, by using a high frequency ultrasound probe, it provides a highly effective postoperative analgesia in the first 12hours.
In this study, we have conducted an ultrasound guided transversus abdominis plane block using a high frequency ultrasound probe”8MHZ” frequency, using the cheaper, time saving, single shot TAP block technique for analgesia of the lower abdominal surgeries like myomectomy, varicocelectomy, oblique inguinal hernia repair, etc.
As there are few studies compared the analgesic efficacy of TAP block to the epidural one for analgesia after lower abdominal surgeries, we choosed the last group as a comparative group using the same and commonest local anaesthetic drug with the same concentration bupivacaine0.25% plus epinephrine 1/ 200.000 to increase its duration of action.
Eighty patients who were undergoing a lower abdominal incisions operation, were divided into two groups, the TAP group and the epidural one, comparing the intraoperative and postoperative analgesic effects of both methods using the postoperative verbal rating score, first time to request analgesia and the total amount of opioid”morphine” used throughout the 1st 24 hours postoperative.
The TAP block showed better results regarding the postoperative analgesia, like lengthier postoperative analgesic period and less postoperative morphine consumption than the epidural technique.
Conclusion:
- TAP block holds considerable promise on account ofits efficacy, low complication rate and simplicity.
- Ultrasound guided transversus abdominis plane block provides analgesia following different types of lower abdominal surgeries; also it reduces the postoperative IV morphine requirements and consequently reduces opioid-mediated side effects.
Recommendations:
- We recommend using the TAP block in everyday practice.
- Further studies are necessary in order to fully characterize the clinical utility, dose response and segments involved in this nerve block.
-Further studies are also needed to investigate the most suitable local anaesthetic agent (type, concentration and volume of injection), efficacy of continuous infusion through a catheter and comparison with epidural analgesia.