Tranversus Abdominis Plane Block in Laparoscopic Surgery
Transversus Abdominis Plane Block in Laparoscopic Surgery
DOI:
https://doi.org/10.54393/pjhs.v3i06.353Keywords:
Periportal local anaesthesia, cholecystectomy and postoperative analgesiaAbstract
Good postoperative pain relief has been observed following various inguinal and abdominal procedures using transversus abdominis plane (TAP) block. Objective: To determine the outcome of laparoscopically assisted transverses abdominis plane block in laparoscopic cholecystectomy in comparison to periportal local anaesthesia in terms of mean pain. Methods: The study was conducted at the Department of General Surgery, Pakistan Atomic Energy Commission Hospital, Islamabad from January 2020 to June, 2020. In this randomized controlled trial, 92 patients underwent elective laparoscopic cholecystectomy were enrolled. Pain score was calculated by visual analogue score at 24 hours post-operatively. Data were entered in SPSS version 25.0. Comparison of both groups was done for pain score using t-test. Data were stratified. The t-test was performed. Results: Total 92 patients underwent elective laparoscopic cholecystectomy were selected foe the study. The subjects were divided into two categories such as Group1 or A (TAP block) and Group 2 or B (Periportal local anaesthesia). In the group A the 34(73.9%) subjects were males while the other 12(26.1%) were females, while in the group B the males were 31(67.4%) and 15(32.6%) were females. Mean VAS was 3.69±1.21 in group-A (TAP block) and 4.26±1.29 in group-B (periportal local anaesthesia) with p-value of 0.033. It is statistically significant. Conclusion: The one of the safest and effective modalities that provide postoperative analgesia with essentially decreased/ less postoperative pain when compared to periportal local anaesthesia is named as laparoscopic assisted TAP block.
References
Tihan D, Totoz T, Tokocin M, Ercan G, Koc Calıkoglu T, Vartanoglu T, et al. Efficacy of laparoscopic transversus abdominis plane block for elective laparoscopic cholecystectomy in elderly patients. Bosnian journal of basic medical sciences. 2016 May; 16(2): 139-44. doi: 10.17305/bjbms.2015.841
Khan KK and Khan RI. Analgesic effect of bilateral subcostal tap block after laparoscopic cholecystectomy. Journal of Ayub Medical College Abbottabad. 2018 Mar; 30(1): 12-5
Wolkewitz M, Schumacher M, Rücker G, Harbarth S, Beyersmann J. Estimands to quantify prolonged hospital stay associated with nosocomial infections. BMC Medical Research Methodology. 2019 Dec; 19(1): 1-6. doi: 10.1186/s12874-019-0752-6
Latenstein CS, Hannink G, van der Bilt JD, Donkervoort SC, Eijsbouts QA, Heisterkamp J, et al. A clinical decision tool for selection of patients with symptomatic cholelithiasis for cholecystectomy based on reduction of pain and a Pain-Free state following surgery. JAMA surgery. 2021 Oct; 156(10): e213706. doi: 10.1001/jamasurg.2021.3706
Ra YS, Kim CH, Lee GY, Han JI. The analgesic effect of the ultrasound-guided transverse abdominis plane block after laparoscopic cholecystectomy. Korean journal of anesthesiology. 2010 Apr; 58(4): 362-8. doi: 10.4097/kjae.2010.58.4.362
Rutherford D, Massie EM, Worsley C, Wilson MS. Intraperitoneal local anaesthetic instillation versus no intraperitoneal local anaesthetic instillation for laparoscopic cholecystectomy. Cochrane Database of Systematic Reviews. 2021 Oct; 10: CD007337. doi: 10.1002/14651858.CD007337.pub4
Pisano M, Allievi N, Gurusamy K, Borzellino G, Cimbanassi S, Boerna D, et al. 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World journal of emergency surgery. 2020 Dec; 15(1): 1-26. doi: 10.1186/s13017-020-00336-x
Wennmacker S, Lamberts M, Gerritsen J, Roukema JA, Westert G, Drenth J, et al. Consistency of patient-reported outcomes after cholecystectomy and their implications on current surgical practice: a prospective multicenter cohort study. Surgical Endoscopy. 2017 Jan; 31(1): 215-24. doi: 10.1007/s00464-016-4959-x
Fisher AT, Bessoff KE, Khan RI, Touponse GC, Maggie MK, Patil AA, et al. Evidence-based surgery for laparoscopic cholecystectomy. Surgery open science. 2022 Oct; 10: 116-34. doi: 10.1016/j.sopen.2022.08.003
Choi GJ, Kang H, Baek CW, Jung YH, Kim DR. Effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy. World journal of gastroenterology. 2015 Dec; 21(47): 13386. doi: 10.3748/wjg.v21.i47.13386
Kim HY, Choi JB, Min SK, Chang MY, Lim GM, Kim JE. A randomized clinical trial on the effect of a lidocaine patch on shoulder pain relief in laparoscopic cholecystectomy. Scientific Reports. 2021 Jan; 11(1): 1-9. doi: 10.1038/s41598-020-80289-y
Ryan JM, O'Connell E, Rogers AC, Sorensen J, McNamara DA. Systematic review and meta-analysis of factors which reduce the length of stay associated with elective laparoscopic cholecystectomy. HPB. 2021 Feb; 23(2): 161-72. doi: 10.1016/j.hpb.2020.08.012
Kim JS, Choi JB, Lee SY, Kim WH, Baek NH, Kim J, et al. Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients: a prospective randomised trial. Medicine. 2016 Aug; 95(31): e4445. doi: 10.1097/MD.0000000000004445
Jung KT, So KY, Kim SC, Kim SH. Effect of nefopam-based patient-controlled analgesia with and without fentanyl on postoperative pain intensity in patients following laparoscopic cholecystectomy: A prospective, randomized, controlled, double-blind non-inferiority trial. Medicina. 2021 Mar; 57(4): 316. doi: 10.3390/medicina57040316
Suragul W, Tantawanit A, Rungsakulkij N, Muangkaew P, Tangtawee P, Mingphrudhi S, et al. Effect of local anaesthetic infiltration on postoperative pain after laparoscopic cholecystectomy: randomized clinical trial. BJS open. 2022 Jun; 6(3): zrac066. doi: 10.1093/bjsopen/zrac066
Choi JJ, Kim K, Park HY, Chang YJ, Lee KC, Kim KY, et al. CONSORT the effect of a bolus dose of dexmedetomidine on postoperative pain, agitation, and quality of recovery after laparoscopic cholecystectomy. Medicine. 2021 Jan; 100(3): e24353. doi: 10.1097/MD.0000000000024353
Jain S, Nazir N, Mustafi SM. Preemptive low-dose intravenous ketamine in the management of acute and chronic postoperative pain following laparoscopic cholecystectomy: a prospective randomized control study. Medical gas research. 2022 Oct; 12(4): 141. doi: 10.4103/2045-9912.337995
Serban D, Socea B, Balasescu SA, Badiu CD, Tudor C, Dascalu AM, et al. Safety of laparoscopic cholecystectomy for acute cholecystitis in the elderly: A multivariate analysis of risk factors for intra and postoperative complications. Medicina. 2021 Mar; 57(3): 230. doi: 10.3390/medicina57030230
Tang CL and Schlich T. Surgical innovation and the multiple meanings of randomized controlled trials: the first RCT on minimally invasive cholecystectomy (1980–2000). Journal of the history of medicine and allied sciences. 2017 Apr; 72(2): 117-41. doi: 10.1093/jhmas/jrw027
Kim EM, Jeon JH, Chung MH, Choi EM, Baek SH, Jeon PH, et al. The effect of nefopam infusion during laparascopic cholecystectomy on postoperative pain. International journal of medical sciences. 2017 May; 14(6): 570. doi: 10.7150/ijms.19021
Guo W, Liu Y, Han W, Liu J, Jin L, Li JS, et al. Randomized trial of immediate postoperative pain following single-incision versus traditional laparoscopic cholecystectomy. Chinese Medical Journal. 2015 Dec; 128(24): 3310-6. doi: 10.4103/0366-6999.171422
Allegri M, Ornaghi M, Ferland CE, Bugada D, Meghani Y, Calcinati S, et al. Peritoneal nebulization of ropivacaine during laparoscopic cholecystectomy: dose finding and pharmacokinetic study. Pain Research and Management. 2017 Jan; 2017: 4260702. doi: 10.1155/2017/4260702
Burke J, Rattan R, Sedighim S, Kim M. A simple risk score to predict Clavien-Dindo Grade IV and V complications after non-elective cholecystectomy. Journal of Gastrointestinal Surgery. 2021 Jan; 25(1): 201-10. doi: 10.1007/s11605-020-04514-9
Kim H, Lee DK, Lee MK, Lee M. Median effective dose of nefopam to treat postoperative pain in patients who have undergone laparoscopic cholecystectomy. Journal of International Medical Research. 2018 Sep; 46(9): 3684-91. doi: 10.1177/0300060518777411
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