Randomized trial of transversus abdominis plane block at total laparoscopic hysterectomy: effect of regional analgesia on quality of recovery

Am J Obstet Gynecol. 2012 Nov;207(5):419.e1-5. doi: 10.1016/j.ajog.2012.06.052. Epub 2012 Jun 29.


Objective: The objective of the study was to determine whether transversus abdominis plane (TAP) block improves the early postoperative quality of recovery (QoR-40). The secondary objectives measured postoperative pain, length of stay, and narcotic use.

Study design: This was a randomized, single-blinded trial of TAP block versus no block on women undergoing laparoscopic hysterectomy. TAP block patients received 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 placed under ultrasound guidance on each side. The outcomes were measured using validated quality of recovery questionnaires (QoR-40), visual analog scales (VAS) for pain, and documented narcotic use in the electronic medical record.

Results: In 58 women, no differences in demographics were noted between groups. Comparisons of pain and recovery between the 2 groups showed no differences. There was no decrease in narcotic use or length of stay among those who received the TAP block.

Conclusions: TAP block does not improve postoperative QoR-40 scores or VAS pain scores following laparoscopic hysterectomy, nor does it decrease narcotic pain medication use.

Trial registration: ClinicalTrials.gov NCT01479270.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abdominal Muscles / diagnostic imaging
  • Abdominal Muscles / drug effects
  • Adult
  • Amides / therapeutic use
  • Analgesia / methods*
  • Anesthetics, Local / therapeutic use
  • Female
  • Humans
  • Hysterectomy / methods*
  • Laparoscopy / methods*
  • Length of Stay
  • Middle Aged
  • Nerve Block / methods*
  • Pain Measurement
  • Recovery of Function / drug effects*
  • Ropivacaine
  • Treatment Outcome
  • Ultrasonography


  • Amides
  • Anesthetics, Local
  • Ropivacaine

Associated data

  • ClinicalTrials.gov/NCT01479270