A randomized comparative study of transversus abdominis plane block (tap) with 0.25% bupivacaine and 0.375% ropivacaine in the duration of post-operative analgesia in upper abdominal laparoscopic surgeries

Abstract

Transversus abdominis plane (TAP) block is a successful postoperative analgesia technique in laparoscopic surgeries. This study compared the analgesic efficacy of 0.25% bupivacaine and 0.375% Ropivacaine in TAP block as post-operative analgesia for upper abdomen laparoscopic surgeries.: This randomized, double-blinded comparative study was conducted at the Dr Jeyasekharan Medical Trust and Nursing Home for 18 months. Seventy-one consenting adult patients undergoing upper abdominal laparoscopic surgeries qualifying the inclusion criteria to undergo Bilateral Subcostal TAP Block were included. The patient was labelled group A or B according to a computer-generated randomization list. TAP block was administered using 30 ml (15 ml on each side) of 0.25% bupivacaine (A) or 0.375% ropivacaine (B). Similar premedication and induction were given to all patients. : Among 71 patients in group A, males were 5 (14.7%), and females were 29 (85.3%). In group B, males were 7 (18.9%), and female was 30 (81.1%). There is no significant difference in gender, age, and BMI between groups. The mean duration of analgesia with 0.375% ropivacaine (10.21±3.36 hrs.) was significantly higher than 0.25% bupivacaine (6.38±2.03 hrs.). In the first 24 hours postoperatively, the mean total tramadol consumption was 147.06±11.94 mg in group A and 117.57±31.11 mg in group B, which is statistically significant.: This study concludes that 0.375% 30ml ropivacaine given as a TAP block under ultrasound guidance significantly prolonged the post-operative analgesia duration compared to 0.25% 30ml bupivacaine.