The analgesic effect of double injection technique intruncal block on the laparotomy of long duration

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We compared the analgesic effect of the transversus abdominis plane (TAP) block with that of continuous epidural block in patients undergoing gynecological laparotomy of long duration. The visual analogue scales (VAS) at rest and at cough during the postoperative 72 hours were not statistically different between TAP block and continuous epidural block. The total consumption of morphine was not statistically different. Then, we compared the analgesic effect of pre-incisional TAP block combined postoperative rectus sheath block (double injection technique) with that of pre-incisional TAP block in patients undergoing pynecological laparotomy of long duration. We also measured the blood concentration of ropivacaine. The VAS at rest and cough during the postoperative 72 hours were not different between the two injection techniques. The total morphine consumption was not different. The blood concentrations of ropivacaine were kept below the level causing local anesthetic toxicity.