الفهرس 
OBESITYOnly 14 pages are availabe for public view
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Abstract
P
oorly controlled acute pain after abdominoplasty is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and an increased likelihood of chronic pain.
The analgesic regimen needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of trauma –induced nociceptive impulses.
Many studies have been carried out trying to find a solution for these dilemma thus different pain modalities as local infiltration of the surgical field, systemic analgesia (narcotics and non narcotics), neuro-axial blocks, and nerve blocks shined out, however each has shown its side effect which limits its use to specific cases.
Abdominal field blocks have been extensively used for a variety of surgical procedures for many years. They are simple to perform and have a good safety profile.
The aim of this study is to assess the analgesic efficacy and hemodynamic effects of bilateral ultrasound guided single injection Transversus Abdominis Plane (TAP) Block compared with intravenous nalbuphine after abdominoplasty. Each of them combined with general anesthesia in patients undergoing abdominoplasty.
The study was conducted on 70 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 35 patients each:
group TAP: bilateral ultrasound guided TAP block was performed before extubation of patients using 20 ml of 0.25% bupivacaine in each side.
group N: received intravenous nalbuphine as post operative analgesia after abdominoplasty.
The two groups were adequately monitored and assessed intra- and post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia and total consumption of nalbuphine in the 1st 24 postoperative hours. Demographic data, intra and post operative hemodynamics.
The results of the study revealed that that single injection tansversus abdominis plane block has more analgesic efficacy than intravenous nalbuphine. The first call for rescue analgesia (nalbuphine), total nalbuphine consumption and pain scores (visual analog score) indicated that the superiority of the analgesic technique (TAP Block) was attributed to their opioid sparing effect.