COMPARISON OF POSTOPERATIVE MEAN OPIOID CONSUMPTION IN PATIENTS GIVEN TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK VERSUS PLACEBO UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY
DOI:
https://doi.org/10.54112/bcsrj.v2022i1.155Keywords:
Laparoscopic cholecystectomy, transverses abdominis plane block, tramadol, AnalgiaAbstract
Early postoperative pain from laparoscopic cholecystectomy is moderate. A transverses abdominis plane block (TAP) may be an attractive analgesic strategy for reducing postoperative opioid consumption and side effects. The study aimed to assess postoperative mean opioid utilization in patients administered (TAP) block versus placebo undergoing laparoscopic cholecystectomy.This randomized controlled trial was conducted at the Department ofAnesthesiology, Aziz Bhatti Shaheed Teaching Hospital Gujrat,from June 1, 2022, toSeptember 30, 2022. A total of80 patients undergoingLaparoscopic cholecystectomy fulfilling inclusion criteria were recruited and further divided into two equal groups. TAP block procedure was performed in both groups. In group A, 40 patients received 20 mL of isotonic saline 0.9% bilaterallyas a placebo, and in group B, 40 patients had 20 mL of 0.5% bupivacaine. The two groups werecompared for the mean consumption dose of opioid analgesia in 24 hours postoperatively. A T-test was appliedfor statistical differences. (p-Value < 0.05 was taken as significant. Data was collected on specially designed proforma.The total tramadol consumption decreased by 35% in the TAP block group (280.19 ± 56.67mg) compared to the control group (428.79 ± 58.69mg), and the difference was statistically significant (p < 0.001).The mean total pain scores were significantly lower in the TAP block group (46.47 ± 6.17) compared to the control group (60.52 ± 5.67). Thus, it can be concluded from the study that theTAP block is an effective analgesia regimen for reducing postoperative mean opioid requirement and painafter Laparoscopic cholecystectomy.
Downloads
References
Bacal, V., Rana, U., McIsaac, D. I., and Chen, I. (2019). Transversus abdominis plane block for post hysterectomy pain: a systematic review and meta-analysis. Journal of minimally invasive gynecology26, 40-52.
Baciarello, M., Migliavacca, G., Marchesini, M., Valente, A., Allegri, M., and Fanelli, G. (2018). Transversus abdominis plane block for the diagnosis and treatment of chronic abdominal wall pain following surgery: a case series. Pain Practice18, 109-117.
Boules, M. L., Goda, A. S., Abdelhady, M. A., Abd, S. A. A. E.-N., and Hamed, M. A. (2020). Comparison of analgesic effect between erector spinae plane block and transversus abdominis plane block after elective cesarean section: a prospective randomized single-blind controlled study. Journal of pain research13, 1073.
El-Dawlatly, A., Turkistani, A., Kettner, S., Machata, A.-M., Delvi, M., Thallaj, A., Kapral, S., and Marhofer, P. (2009). Ultrasound-guided transversus abdominis plane block: description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy. British journal of anaesthesia102, 763-767.
Elamin, G., Waters, P. S., Hamid, H., O'Keeffe, H. M., Waldron, R. M., Duggan, M., Khan, W., Barry, M. K., and Khan, I. Z. (2015). Efficacy of a laparoscopically delivered transversus abdominis plane block technique during elective laparoscopic cholecystectomy: a prospective, double-blind randomized trial. Journal of the American College of Surgeons221, 335-344.
Fayezizadeh, M., Majumder, A., Neupane, R., Elliott, H. L., and Novitsky, Y. W. (2016). Efficacy of transversus abdominis plane block with liposomal bupivacaine during open abdominal wall reconstruction. The American Journal of Surgery212, 399-405.
Franco, C. D., and Inozemtsev, K. (2020). Refining a great idea: the consolidation of PecS I, PecS II and serratus blocks into a single thoracic fascial plane block, the sap block. Regional Anesthesia & Pain Medicine45, 151-154.
Guerra, L., Philip, S., Lax, E. A., Smithson, L., Pearlman, R., and Damadi, A. (2019). Transversus abdominis plane blocks in laparoscopic colorectal surgery: better pain control and patient outcomes with liposomal bupivacaine than bupivacaine. The American Surgeon85, 1013-1016.
Hoofwijk, D., Fiddelers, A. A., Peters, M. L., Stessel, B., Kessels, A. G., Joosten, E. A., Gramke, H.-F., and Marcus, M. A. (2015). Prevalence and predictive factors of chronic postsurgical pain and poor global recovery 1 year after outpatient surgery. The Clinical journal of pain31, 1017-1025.
Mrunalini, P., Raju, N. V. R., Nath, V. N., and Saheb, S. M. (2014). Efficacy of transversus abdominis plane block in patients undergoing emergency laparotomies. Anesthesia, Essays and Researches8, 377.
Park, J.-M., and Lee, J. (2022). Effect of transversus abdominis plane block on the quality of recovery in laparoscopic nephrectomy: A prospective double-blinded randomized controlled clinical trial. Medicine101, e31168.
Ra, Y. S., Kim, C. H., Lee, G. Y., and Han, J. I. (2010). The analgesic effect of the ultrasound-guided transverse abdominis plane block after laparoscopic cholecystectomy. Korean journal of anesthesiology58, 362-368.
Tsai, H.-C., Yoshida, T., Chuang, T.-Y., Yang, S.-F., Chang, C.-C., Yao, H.-Y., Tai, Y.-T., Lin, J.-A., and Chen, K.-Y. (2017). Transversus abdominis plane block: an updated review of anatomy and techniques. BioMed research international2017.
van Dijk, J. F., van Wijck, A. J., Kappen, T. H., Peelen, L. M., Kalkman, C. J., and Schuurmans, M. J. (2015). The effect of a preoperative educational film on patients' postoperative pain in relation to their request for opioids. Pain Management Nursing16, 137-145.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 B AVAIS, HM JAVED, NG SHEIKH, MG SHEIKH, B JAMSHAID, Z BUTT
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.