• Jesper O Røjskjaer, Erik Gade, Louise B Kiel, Morten N Lind, Lars M Pedersen, Billy B Kristensen, Yvonne H Rasmussen, and Nicolai B Foss.
• Department of Anesthesia, Hvidovre University Hospital, Hvidovre, Denmark.
• Acta Obstet Gynecol Scand. 2015 Mar 1;94(3):274-8.

ObjectiveTo assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen.DesignA randomized, double-blind, placebo-controlled trial following the CONSORT criteria.SettingHvidovre University Hospital.PatientsForty-six women scheduled for total abdominal hysterectomy.InterventionWomen received either ropivacaine 0.75%, 20 mL (n = 24) or 0.9% saline, 20 mL (n = 24) in the transversus abdominis plane on each side.Main Outcome MeasuresPrimary outcome was the 24-h postoperative morphine consumption. Secondary outcomes were pain scores at rest and during coughing, postoperative nausea and vomiting at 1, 2, 4, 6, 8, and 24 h, and time to first mobilization.ResultsThere was no difference in the mean 24-h postoperative morphine consumption between the two groups (p = 0.733). The ropivacaine group had significantly lower median pain scores at 1 h (p = 0.008) and 2 h (p = 0.027) postoperatively at rest and at 8 h (p = 0.028) during coughing. There was no significant difference in other secondary outcomes.ConclusionThere was no reduction in 24-h morphine consumption when using an ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period.© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

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