Comparison of lumbar epidural analgesia, transversus abdominis plane block, and surgical wound infiltration for postoperative pain relief in patients with major gynecologic surgery

Cansu Demir; Mediha Türktan; Ersel Güleç; Mete Sucu; Hülya Binokay; Hakki Ünlügenç

Makale detayları

Comparison of lumbar epidural analgesia, transversus abdominis plane block, and surgical wound infiltration for postoperative pain relief in patients with major gynecologic surgery

Yazarlar:

Cansu Demir | Mediha Türktan | Ersel Güleç | Mete Sucu | Hülya Binokay | Hakki Ünlügenç

Yayıncı:

Cukurova University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Cukurova Medical Journal Vol.50 Issue 3, pp.819-828

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357852

pISSN:

2602-3032

Anahtar kelimeler:

Özet:

 Purpose: This study compared lumbar epidural analgesia LEA, transversus abdominis plane TAP block, and surgical wound infiltration SWI for postoperative analgesia, patient satisfaction, and side effects in major gynecologic surgery. Materials and Methods: Eighty-one patients were randomized into three groups: lumbar epidural block Group LEA, TAP block Group TAP, and SWI Group SWI. Demographic data, surgical characteristics, hemodynamic variables, total morphine consumption, time to first rescue analgesia, pain scores, and side effects were recorded at 1, 2, 6, 12, 24, 36, and 48 hours, along with patient satisfaction scores at 24 and 48 hours postoperatively. Results: Heart rate was significantly lower in Group LEA than in Group SWI and Group TAP. Postoperative 48-h total morphine consumption was significantly lower in Group LEA 9.63  5.7 mg than in Group TAP 15.30  4.0 mg and Group SWI 16.93  5.9 mg. Postoperative pain scores were significantly lower in Group LEA than in the other groups. Time to first rescue analgesia was significantly longer in Group LEA 47.41  24.3 min than in Group TAP 27.41  11.9 min and Group SWI 16.67  5.1 min. Patient satisfaction scores were significantly higher at 24 and 48 hours in Group LEA 9.89  0.3 and 9.96  0.1, respectively than in Group TAP 9.67  0.5 and 9.89  0.3 and Group SWI 9.37  0.8 and 9.44  0.7. No significant side effects were noted. Conclusion: In patients undergoing major gynecologic surgery, LEA resulted in lower morphine consumption, longer time to first rescue analgesic request, and higher patient satisfaction scores without increasing the risk of side effects compared to TAP block and SWI.

 Purpose: This study compared lumbar epidural analgesia LEA, transversus abdominis plane TAP block, and surgical wound infiltration SWI for postoperative analgesia, patient satisfaction, and side effects in major gynecologic surgery. Materials and Methods: Eighty-one patients were randomized into three groups: lumbar epidural block Group LEA, TAP block Group TAP, and SWI Group SWI. Demographic data, surgical characteristics, hemodynamic variables, total morphine consumption, time to first rescue analgesia, pain scores, and side effects were recorded at 1, 2, 6, 12, 24, 36, and 48 hours, along with patient satisfaction scores at 24 and 48 hours postoperatively. Results: Heart rate was significantly lower in Group LEA than in Group SWI and Group TAP. Postoperative 48-h total morphine consumption was significantly lower in Group LEA 9.63  5.7 mg than in Group TAP 15.30  4.0 mg and Group SWI 16.93  5.9 mg. Postoperative pain scores were significantly lower in Group LEA than in the other groups. Time to first rescue analgesia was significantly longer in Group LEA 47.41  24.3 min than in Group TAP 27.41  11.9 min and Group SWI 16.67  5.1 min. Patient satisfaction scores were significantly higher at 24 and 48 hours in Group LEA 9.89  0.3 and 9.96  0.1, respectively than in Group TAP 9.67  0.5 and 9.89  0.3 and Group SWI 9.37  0.8 and 9.44  0.7. No significant side effects were noted. Conclusion: In patients undergoing major gynecologic surgery, LEA resulted in lower morphine consumption, longer time to first rescue analgesic request, and higher patient satisfaction scores without increasing the risk of side effects compared to TAP block and SWI.

 Purpose: This study compared lumbar epidural analgesia LEA, transversus abdominis plane TAP block, and surgical wound infiltration SWI for postoperative analgesia, patient satisfaction, and side effects in major gynecologic surgery. Materials and Methods: Eighty-one patients were randomized into three groups: lumbar epidural block Group LEA, TAP block Group TAP, and SWI Group SWI. Demographic data, surgical characteristics, hemodynamic variables, total morphine consumption, time to first rescue analgesia, pain scores, and side effects were recorded at 1, 2, 6, 12, 24, 36, and 48 hours, along with patient satisfaction scores at 24 and 48 hours postoperatively. Results: Heart rate was significantly lower in Group LEA than in Group SWI and Group TAP. Postoperative 48-h total morphine consumption was significantly lower in Group LEA 9.63  5.7 mg than in Group TAP 15.30  4.0 mg and Group SWI 16.93  5.9 mg. Postoperative pain scores were significantly lower in Group LEA than in the other groups. Time to first rescue analgesia was significantly longer in Group LEA 47.41  24.3 min than in Group TAP 27.41  11.9 min and Group SWI 16.67  5.1 min. Patient satisfaction scores were significantly higher at 24 and 48 hours in Group LEA 9.89  0.3 and 9.96  0.1, respectively than in Group TAP 9.67  0.5 and 9.89  0.3 and Group SWI 9.37  0.8 and 9.44  0.7. No significant side effects were noted. Conclusion: In patients undergoing major gynecologic surgery, LEA resulted in lower morphine consumption, longer time to first rescue analgesic request, and higher patient satisfaction scores without increasing the risk of side effects compared to TAP block and SWI.

 Amaç: Çalışmamızda major jinekolojik cerrahide lomber epidural analjezi LEA, transversus abdominis plan TAP bloğu ve cerrahi yara infiltrasyonunu SWI postoperatif analjezi, hasta memnuniyeti ve yan etkiler açısından karşılaştırdık. Gereç ve Yöntem: Seksen bir hasta üç gruba randomize edildi: lomber epidural blok Grup LEA, TAP blok Grup TAP ve cerrahi yara infiltrasyonu Grup SWI. Demografik veriler, cerrahi özellikler, hemodinamik değişkenler, toplam morfin tüketimi, ilk kurtarma analjezik isteğine kadar geçen süre, ağrı skorları ve yan etkiler postoperatif 1, 2, 6, 12, 24, 36 ve 48. saatlerde kaydedildi. Hasta memnuniyeti skorları da postoperatif 24 ve 48. saatlerde kaydedildi. Bulgular: Kalp hızı Grup LEAda diğer gruplara kıyasla daha düşüktü. Ameliyat sonrası 48 saatlik toplam morfin tüketimi Grup LEAda 9,635,7 mg, Grup TAPa 15,304,0 mg ve Grup SWIa 16,935,9 mg göre anlamlı derecede düşüktü. Ameliyat sonrası ağrı skorları Grup LEAda diğer gruplara göre anlamlı derecede düşüktü. İlk kurtarma analjezisine kadar geçen süre Grup LEAda 47,4124,3 dk, Grup TAPa 27,4111,9 dk ve Grup SWIya 16,675,1 dk göre anlamlı derecede uzundu. Hasta memnuniyeti skorları 24 ve 48. saatlerde Grup LEAda 9,890,3 ve 9,960,1 Grup TAPa 9,670,5 ve 9,890,3 ve Grup SWIya 9,370,8 ve 9,440,7 göre anlamlı derecede yüksekti. Postoperatif önemli bir yan etki görülmedi. Sonuç: Majör jinekolojik cerrahi geçiren hastalarda LEA TAP blok ve SWI ile karşılaştırıldığında yan etki riskini artırmadan daha düşük morfin tüketimi, ilk kurtarma analjezi süresinde uzama ve daha yüksek hasta memnuniyet skorları ile sonuçlandı.

Makale detayları

Comparison of lumbar epidural analgesia, transversus abdominis plane block, and surgical wound infiltration for postoperative pain relief in patients with major gynecologic surgery

Yazarlar:

Cansu Demir | Mediha Türktan | Ersel Güleç | Mete Sucu | Hülya Binokay | Hakki Ünlügenç

Yayıncı:

Cukurova University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Cukurova Medical Journal Vol.50 Issue 3, pp.819-828

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357852

pISSN:

2602-3032

epidural analgesia

gynecologic surgery

local anesthetic infiltration

postoperative pain management

side effect

transversus abdominis plane blockepidural analjezi

jinekolojik cerrahi

lokal anestezik infiltrasyonu

postoperatif ağrı yönetimi

yan etki

transversus abdominis alan bloğu

Sayı

Makale detayları

Yazarlar: Cansu Demir | Mediha Türktan | Ersel Güleç | Mete Sucu | Hülya Binokay | Hakki Ünlügenç

Yayıncı: Cukurova University

Ana Başlıklar: Anesteziyoloji

Dergi: Cukurova Medical Journal Vol.50 Issue 3, pp.819-828

Belge Tipi: Makale

Yayın Tarihi: 9/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001357852

pISSN: 2602-3032

Sayı

Yazarlar:

Cansu Demir | Mediha Türktan | Ersel Güleç | Mete Sucu | Hülya Binokay | Hakki Ünlügenç

Yayıncı:

Cukurova University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Cukurova Medical Journal Vol.50 Issue 3, pp.819-828

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357852

pISSN:

2602-3032