Background
postoperative pain, pain
ADVERSE EFFECTS, SECONDARY
Enhanced recovery after surgery (ERAS) protocols are designed to minimize the stress response created by surgery and to improve patient recovery after surgery [Ultrasound-guided transversus abdominis plane (TAP) block is performed by injecting local anesthetic between the muscle layers of the trunk. As an effective pain relief technique, it has been performed in various abdominal surgical procedures. Current evidence has revealed consistent results in terms of reducing pain and opioid requirements after surgery, especially for gynecologic surgery, appendectomy, and bariatric surgery [The analgesic efficacy of the TAP block is also influenced by several factors such as dose of local anesthetics, different approach used, and inclusion of co-analgesics [Open gynecological surgeries are known to cause moderate to severe postoperative pain. In this randomized controlled study, we aimed to investigate whether adding preoperative TAP block to MMA protocol would confer additional benefit after open gynecologic surgery for benign indications. We hypothesized that preoperative TAP block had further preventive analgesic effect when used as part of MMA. The primary outcome was rescued morphine within 24 h after surgery. The secondary outcomes were pain scores, adverse effects and quality of recovery measured by a 40-item quality of recovery score (QoR-40) at 24 h and the short-form health survey (SF-36) on postoperative day 30.