Impact of TAP-block on the Surgical Stress Response after Abdominal Hysterectomy

M.S. Rybin, R.A. Tkachenko


Purpose of the research was to analyze the various options of postoperative analgesia in terms of their influence on the symptoms of surgical stress response in order to optimize the method of analgesia. Patients (n = 105) were divided into three groups depending on the method of postoperative analgesia. We have monitored the performance of the heart rate variability, the level of daily urine cortisol, as well as changes in the level of blood glucose. The study showed the activation of the regions of the autonomic nervous system in the control group was not significant. In group II, autonomic dysfunction with an increased tone of parasympathetic area has been detected. The use of TAP-block has been characterized by the activation of the regions of the autonomic nervous system. Postoperative hyperglycemia was observed in all groups. The highest rates were in the control group, in group II and III glucose level was lower. Indicators of urine cortisol excretion in the control group were 3 times higher than normal ones. In group II and III — 2.1 and 2.2 times higher, respectively. Increased excretion of daily cortisol indicates the presence of surgical stress in the postoperative period. The use of TAP-block in the postoperative period is characterized by the preservation of adaptive-compensatory reactions in response to surgical intervention, which has an obvious advantage over other methods of postoperative analgesia.


postoperative analgesia; TAP block; surgical stress response


Farragher R.A., Laffey J.G. Postoperative pain management following cesarean section // Postoperative pain management: an ­evidence-based guide to practice: 1st ed. — ​Philadelphia, PA: Saunders Elsevier, 2006. — ​С. 225-38.

Stanley G. et al. Dose requirements, efficacy and side effects of morphine and pethidine delivered by patient-controlled analgesia after gynaecological surgery // British journal of anaesthesia. — 1996. — ​Т. 76, № 4. — ​С. 484-486.

Forero M. et al. Lumbar transversus abdominis plane block: the role of local anesthetic volume and concentration — a pilot, prospective, randomized, controlled trial // Pilot and Feasibility Studies. — 2015. — ​Т. 1, № 1. — ​С. 10.

Rafi A.N. Abdominal field block: a new approach via the lumbar triangle // Anaesthesia. — 2001 Oct. — 56(10). — 1024-1026.

Jankovic Z.B., Pollard S.G., Nachiappan M.M. Continuous transversus abdominis plane block for renal transplant recipients // Anesthesia & Analgesia. — 2009. — ​Т. 109, № 5. — ​С. 1710-1711.

Hebbard P.D., Barrington M.J., Vasey C. Ultrasound-guided continuous oblique subcostal transversus abdominis plane blockade: description of anatomy and clinical technique // Regional anesthesia and pain medicine. — 2010. — ​Т. 35, № 5. — ​С. 436-441.

Різник Л. Варіабельність серцевого ритму як індикатор вегетативного балансу та глибини наркозу. 20-річний досвід застосування в анестезіології. Варіабельність серцевого ритму та загальна анестезія. Чи на сьогодні реально можливо оцінити вегетативний баланс та глибину наркозу? // Біль, знеболювання і інтенсивна терапія. — 2005. — № 1. — ​С. 28-37.



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