Document resource
Background and Aims Emergency abdominal surgeries require an effective multimodal analgesia strategy to optimize clinical outcomes. We present the primary results of a prospective observational study investigating the perioperative efficacy of TAP block in patients undergoing emergency abdominal procedures.Methods 11 patients, 25–66 years old, ASA I-II, underwent open (36.4%) or laparoscopic (63.6%) emergency abdominal surgery. Following induction of general anaesthesia, bilateral, ultrasound-guided TAP block was performed using a total of 40 ml of Ropivacaine 0.375%. Intraoperative analgesia with remifentanil titration was guided by Nociception Level Index and 30 minutes before surgical completion, paracetamol and nalbuphine was administered. Postoperative analgesia included paracetamol every 8 hours and tramadol as rescue analgesia for the first 24 hours. This observational study (reference number 2024-B2015–401) was approved by the hospital’s ethical and scientific committee.Results The average perioperative administration of remifentanil was 200 mcg, with a median NOL index of 16. PACU stay averaged 20 minutes and the median NRS pain score was 3. During the first 12 postoperative hours, the median NRS was 5, declining to 4 at 24 hours. Rescue analgesia was required in 10 patients. Median patient satisfaction was 4.7/6 and the mean 24-hour Quality of Recovery score was 96.6/150. Median time to mobilization, oral fluid intake, and food intake was 13.5, 12.4, and 20.6 hours, respectively.Conclusions The preoperative performance of bilateral TAP block is an effective adjunct in multimodal analgesia to patients undergoing emergency abdominal surgery, enhancing postoperative recovery, reducing opioid requirements and facilitating early mobilization and nutritional intake.