COMPARATIVE STUDY TO ASSES ANALGESIC EFFICACY AND OPIOID SPARING EFFECT OF USG GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH INTRAPERITONEAL INSTILLATION OF BUPIVACAINE IN PATIENT UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY FOR POSTOPERATIVE PAIN RELIEF.

Abstract

Background- Intensity of pain in early post-operative period after laparoscopic cholecystectomy is signicant. There are several methods employed in the management of postoperative pain after laparoscopic cholecystectomy such as conventional systemic analgesics, including paracetamol, non-steroidal anti-inammatory drugs, systemic opioids, and thoracic epidural analgesia with all having its limitations and side effects. Objective- The present study aims to compare ultrasound-guided subcostal transversus abdominis (STA) block with intraperitoneal instillation of bupivacaine in reducing postoperative pain, total analgesic consumptions after elective laparoscopic cholecystectomy. Materials and methods: 60 adult patients were randomly divided into 2 groups of 30 in each. The selected patients were randomly divided into two groups Group 1, patients received USG guided tap block before surgery. Group 2 patients received 40 ml of 0.25 % bupivacaine after surgery, instillation done by surgeon intraperitoneally at gall blabber bed and under the domes of diaphragm. Statistical analysis: In all Quantitative data were expressed in mean and standard deviation. Qualitative data were expressed in proportion and percentages. To nd the signicant difference between the bivariate samples in independent groups the Unpaired sample t-test and the Mann-Whitney U test was used. Above statistical tools the probability value > .05 was considered as signicant level. Results: The mean Numerical Rating Scale scores were less in Group 1 than in Group 2 from 1 hours to 24 hours and it was statistically signicant. Demand of rescue analgesia was higher in group 2 when compared to group 1 and it was statistically signicant. Conclusion: TAP block is a better modality for analgesia compared to intraperitoneal instillation in patients undergoing elective laparoscopic cholecystectomy