The goal of this study is to know how effectively TAP block can reduce postoperative pain in total abdominal hystrectomy patients when given ketamine in addition to bupivacaine in TAP block and to compare it with the conventional TAP block with bupivacaine only. The main question it aims to answer is:
Does intervention with ketamine in TAP block lowers the postoperative pain measured via visual analog scale and decreases the need for rescue analgesia?
Patients will be assessed for pain in PACU( post anesthesia care unit), 6 hours, 12 hours and 24 hours postoperatively. Time of rescue analgesia will also be noted if given.
Aged between 25 to 60 years.
ASA grade I & II.
Undergoing total abdominal hysterectomy.
BMI >35kg/m2.
Patient refusal for participation.
Patients with coagulation disorders.
Patents with history of allergy and hypersensitivity to local anesthetic.
Parallel
bupivicaine 0.25%
Drug20ml of 0.25% bupivacaine inTAP block
bupivicaine 0.25% + ketamine
Drug20ml of 0.25% of bupivacaine with 50mg ketamine in TAP block
VAS score
VAS (visual analog scale ) score noted VAS of \<2 = no pain VAS of 2-4 = mild pain VAS of 5-6 = moderate pain VAS of \>6 = severe pain
Time of receiving first rescue analgesia
time for additional requirment of inj. tramadol 50mg for post operative pain relief
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