الفهرس 
Anatomy of Anterior Abdominal WallOnly 14 pages are availabe for public view
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Abstract
Background: Postoperative pain management is becoming an integral part of anaesthesia care. Various techniques of pain relief have been designed among which the most commonly practiced are peripheral nerve blocks. We have designed the study to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability, and total need of analgesics and opioids after adding morphine to levobupivacaine in TAP block for open appendectomy. A substantial component of the pain experienced by patients after major abdominal surgery is derived from the abdominal wall incision. The abdominal wall consists of three muscle layers, the external oblique, the internal oblique and the transversus abdominis, and their associated fascial sheaths. This muscular wall is innervated by nerve afferents that course through the transversus abdominis neuro-fascial plane. Different adjuvants have been studied to improve the quality and increase the duration of local anaesthetics during various nerve block techniques.
Aim of the work: The aim of this study is to assess the analgesic effect of peripherally administered morphine with levobupivacaine for ipsilateral TAP block in patients undergoing appendectomy under general anaesthesia.
Patient and Methods:
• Type of Study: prospective, randomized and double blind controlled clinical trial.
• Study Setting: Ain Shams University Hospitals.
• Study Period: 6 months.
• Sampling Method: randomized double blind clinical trial.
suction evacuation for molar pregnancy, all cases were included in the study were agreed on a consent for inclusion in the current study after explanation for the details of the study.
Conclusion: TAP block was effective in reducing postoperative pain scores, lowering total 24-h postoperative analgesic consumption. Morphine as an adjunct to levobupivacaine in ipsilateral ultrasound guided transversus abdominis plane block as more effective postoperative analgesia with reduced analgesic requirement in patients undergoing appendectomy.