Incorporating Transversus Abdominis Plane Block in Hysterectomy Anesthesia: Clinical Outcomes in a Hispanic Population.

Background Effective postoperative pain management is essential to enhancing recovery after abdominal hysterectomy. Enhanced Recovery After Surgery (ERAS) protocols recommend opioid-sparing, multimodal analgesia, including regional techniques such as the transversus abdominis plane (TAP) block. Although evidence supports its use, data on its effectiveness in underrepresented populations remain limited. This study evaluated the impact of the TAP block on postoperative recovery in a Hispanic female population. Methodology We conducted a retrospective cohort study at St. Luke's Episcopal Hospital, a tertiary medical center in Ponce, Puerto Rico. Medical records of 300 Hispanic women aged ≥21 years who underwent elective abdominal hysterectomy between August 2023 and September 2024 were reviewed. Patients were grouped based on receipt of a TAP block in addition to general anesthesia. Outcomes included time to ambulation, return of bowel function, hospital length of stay, time to first analgesic request, and incidence of constipation. Statistical analysis included t-tests and chi-square tests. Results Patients in the TAP block group demonstrated significantly better early ambulation, with 81 (98.8%) ambulating by postoperative day (POD) 1 compared to 197 (90.8%) in the control group. Bowel function recovery was similar on POD 1, 35 (42.7%) TAP vs. 101(46.3%) control, but significantly improved by POD 2 in the TAP group, 81 (98.8%) vs. 196 (89.9%) in the control group. Mean hospital stay was shorter in the TAP group (1.93 vs. 2.05 days). Time to first analgesic request was longer (115.5 vs. 88.6 minutes), and constipation incidence was lower 0 (0%) in the TAP group vs. 14 (6.4%), with a significant finding of P = 0.014. Conclusions TAP block use during abdominal hysterectomy improved recovery outcomes, reduced opioid-related side effects, and demonstrated benefit in an entirely Hispanic cohort. These findings support its integration into multimodal analgesia protocols for gynecologic surgery.