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Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy.

Abstract：

OBJECTIVE:To evaluate and compare intercostal-iliac transversus abdominis plane (TAP) and oblique subcostal TAP (OSTAP) blocks for multimodal analgesia in patients receiving laparoscopic cholecystectomy. DESIGN:A prospective, randomized, double-blinded clinical study. SETTING:Operating room, postoperative recovery area, and ward. PATIENTS:In total, 60 laparoscopic cholecystectomy patients (43 women, 17 men, American Society of Anesthesiologists grades I-II) were enrolled from the general surgery department of our tertiary care center. INTERVENTION:The patients were assigned to 1 of the 3 groups. Group 1 received TAP blocks (n=20), group 2 received OSTAP blocks (n=20), and group 3 patients were used as controls and received patient-controlled analgesia (PCA) only (n=20). After the induction of anesthesia, blocks were performed bilaterally in study groups 1 and 2, using 20mL of lidocaine (5mg/mL). PCA with intravenous tramadol was routinely provided for all patients during the first 24hours. MEASUREMENTS:The intraoperative use of remifentanil, postoperative visual analog scale (VAS) scores, demand for PCA, and total analgesic consumption were recorded. MAIN RESULTS:The patients in the control group had greater analgesic demands and analgesic consumption than did those in groups 1 and 2. However, patients in the OSTAP group had lower VAS scores than did those in groups 1 and 3. RESULTS:The demand for analgesia was greater in the control group than in groups 1 and 2. Moreover, lower VAS scores were recorded in the OSTAP group than in groups 1 and 3 and were positively correlated with total PCA consumption among all patients. However, postoperative VAS scores were negatively correlated with the total intraoperative consumption of remifentanil at 24hours. CONCLUSIONS:TAP and OSTAP blocks improved postoperative analgesia in patients receiving laparoscopic cholecystectomy, which resulted in lower VAS scores and reduction in total analgesic consumption.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Oksar M,Koyuncu O,Turhanoglu S,Temiz M,Oran MC

doi

10.1016/j.jclinane.2016.03.033

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

72-8

eissn

0952-8180

issn

1873-4529

pii

S0952-8180(16)30063-0

journal_volume

pub_type

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Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy.