Efficacy of the subcostal transversus abdominis plane block in laparoscopic cholecystectomy: Comparison with conventional port-site infiltration

Objective: To compare the efficacy of ultrasound guided subcostaltransversus abdominis plane block and port site infiltration of local anaesthesia in patients undergoing laparoscopic cholecystectomy. Study Design: Comparative cross sectional study. Place and Duration of Study: Anesthesiology department, Pak Emirates Military Hospital, Rawalpindi, from Jan to Jun 2019. Methodology: A sample size of 62 patients calculated by World Health Organization calculator were randomized in a doubleblind study to undergo Sub costal transversus abdominis plane block or port site infiltration by non-probability, consecutive sampling into two equal groups. Group A received sub costal transversus abdominis plane block and group B local anaesthetic. Postoperative pain perception was measured using visual analogue scale. Results: The mean age of patients in group A was 33.39 ± 8.91 years and in group B was 33.77 ± 8.45 years. Out of 62 patients 38 (61.29%) were males and 24 (38.71%) were females. Mean pain score in group A (ultrasound guided sub costal transversus abdominis plane block) was 1.61 ± 0.91 while in group B (port site infiltration of local anaesthetic) was 3.61 ± 1.05 (p-value 0.0001). Conclusion: The mean pain score was less following use of ultrasound guided sub costal transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy as compared to port site infiltration of local anaesthesia.

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COMPARING THE POST-OPERATIVE ANALGESIA USING ROPIVACAINE IN LAPAROSCOPIC CHOLECYSTECTOMY BY THREE DIFFERENT METHODS-A COMPARATIVE STUDY

10.36106/ijsr/0509158 ◽

2021 ◽

pp. 16-19

Author(s):

Nimta Kishore ◽

Trilok Chand ◽

Narendra Singh Poniya ◽

Arpita Saxena

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Pain Relief ◽

Transversus Abdominis Plane Block ◽

Port Site ◽

Transversus Abdominis ◽

Postoperative Pain Relief ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Intraperitoneal Instillation

Introduction: Laparoscopic cholecystectomy is a minimally invasive surgical procedure for cholecystectomy. In present time local anesthesia is widely used as analgesic by various routes including port site intraincisional inlteration, transverse abdominis plane (TAP) block and intraperitoneal instillation. Aim: Comparing The Post-Operative Analgesia Using Ropivacaine in Laparoscopic Cholecystectomy by three Different Methods ; Intraperitoneal instillation, USG-guided subcostal transversus abdominis plane block and Incisional inltration at port site. Materials and methods: This study was conducted among elective general surgical patient undergoing laparoscopic cholecystectomy in S.N. Medical College, Agra and completed in the study period of 18 months. Study population was elective surgical patients posted for elective laparoscopic cholecystectomy. Patients were divided in to 3 groups: Group A- Intraperitoneal instillation, Groups B- ultrasound guided subcostal transversus abdominis plane block and Groups C- intraincisional inlteration at port site. Results: Intraincisional inltration of ropivacaine provide signicant Postoperative pain relief in comparative to USG -guided subcostal TAP block and intraperitoneal instillation with ropivacaine. Conclusion: Intraincisional inltration of ropivacaine provide signicant Postoperative pain relief and decrease post operative analgesia requirement in comparative to USG -guided subcostal TAP block and intraperitoneal instillation with ropivacaine. Shoulder tip pain incidence, postoperative nausea and vomiting incidence lower in intraincisional inltration of ropivacaine.

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Efficacy of The Subcostal Transversus Abdominis Plane Block In Laparoscopic Cholecystectomy: A Comparison With Conventional Port- Site Infiltration

Journal of KIST Medical College ◽

10.3126/jkistmc.v2i2.33578 ◽

2020 ◽

Vol 2 (2) ◽

pp. 42-47

Author(s):

Kalpana Kharbuja ◽

Jeevan Singh ◽

Sangina Ranjit ◽

Barun Bahadur Pradhan ◽

Ashish Shrestha ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Visual Analogue Score ◽

Transversus Abdominis Plane Block ◽

Opioid Consumption ◽

Port Site ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Ultrasound Guided ◽

Post Operative Pain

Introduction: Pain experienced following laparoscopic cholecystectomy derives significantly from incision made in anterior abdominal wall. Many patients experience moderate to severe pain following laparoscopic cholecystectomy. This study aimed to compare the efficacy of ultrasound guided bilateral subcostal transversus abdominal plane (TAP) block with port-site infiltration for post-operative analgesia after laparoscopic cholecystectomy. Methods: Sixty patients undergoing laparoscopic cholecystectomy were randomly allocated to two groups to receive port-site infiltration of local anaesthesia or ultrasound guided subcostal TAP block at the end of surgery before extubation. All patients received 1 gm paracetamol intravenously 8 hourly. Post-operative pain was assessed using visual analogue score at 0,1,2,4,8,16 and 24 hours. Time to first analgesic requirement and total opioid consumption over 24 hours were recorded. Results: Ultrasound guided bilateral subcostal transversus abdominis plane block significantly reduced post-operative pain score compared to port site infiltration. We observed statistically significant differences in visual analogue score between two groups at all other time frame. The 24 hours opioid consumption was less in Subcostal TAP (136±66.31μg VS 202±80.58μg, p=0.001). Time for rescue analgesia was prolonged in patient receiving subcostal TAP (3.63±2.09 hrs VS 1.73±1.60 hrs, p=0.0002). Conclusion: Ultrasound guided bilateral subcostal transversus abdominal block provides superior post-operative analgesia and reduced opioid consumption after laparoscopic cholecystectomy compared to port-site infiltration.

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