COMPARISON BETWEEN ULTRASOUND GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK AND LOCAL ANESTHETIC INFILTRATION IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background: Post-laparoscopy analgesia of laparoscopic cholecystectomy is still a challenge. Many studies have been carried out to find the effect of different analgesic techniques in patients undergoing laparoscopic cholecystectomy including ultrasonic guided TAP block &wound infiltration of local anesthetic. Objective: To assess degree of pain control, duration of action, duration of postoperative analgesia, the effect on postoperative analgesic requirements in patients undergoing laparoscopic cholecystectomy and compare between Transversus abdominis plane block and local wound infiltration. Methods: 60 cases were enrolled for laparoscopic cholecystectomy and were divided randomly into two groups: TAP group: (n=30) patients of this group received TAP block performed by ultrasound guidance and LWI group (n=30) patients of this group received local anesthetic (ropivacaine).After surgery, Visual Analogue Score (VAS) was recorded at 1, 2,4,6,12,18 &24 hours. Requirement of rescue analgesia when VAS score ≥4, total dose of morphine received in 24 h were noted in both groups postoperatively. Results: The overall VAS during the first postoperative 24 hours was significantly lower in TAP group (P <0.001at 6, 12, 18 and 24 hours after surgery) and total analgesic consumption (morphine in mg) was lower in TAP group (8.2 mg) compared to LWI (12.2 mg). Conclusion: TAP block provides better postoperative pain control & reduce postoperative opioid requirement in comparison with local wound infiltration in patients undergoing laparoscopic cholecystectomy.