The ambulatory management after laparoscopic hysterectomy is a reality in our service, where
90% of hysterectomies are laparoscopically done and 80% of these are managed on an ambulatory
basis with shorter hospital stay ;less than 12 hours. (OALOS 9.41 + / - (1.79) range from 5
to 12 hours and POLE 5.38 + / - (1.8) range from 2 to 9 hours)
So far the immediate analgesic management has been made systemically, and the satisfaction
reported by patients was high, even though some patients require longer stay in recovery and
need higher doses of analgesics before their discharge criteria, allowing an optimal
There are several treatment options that theoretically could be used but the results have
been variable and have failed to demonstrate the expected benefit.
The Transversus Abdominis Plane Block consists in the deposition of local anesthetic in the
plane between the internal oblique and transverse abdominal, looking to infiltrate the spinal
nerves at this level, so the innervation to the skin, muscles and the parietal peritoneum
will be interrupted. The TAP Block was first described in 2001 , based on anatomy marks
techniques of the peripheral nerves and was developed and evaluated later by McDonnell et al.