Efficacy of ultrasound-guided subcostal transversus abdominis plane block for analgesia after laparoscopic cholecystectomy

Abstract

Introduction: Subcostal transversus abdominis plane (TAP) block involves nerves of anterior abdominal wall. In the present study, the primary objective was to find out whether subcostal TAP block reduces the requirement of rescue analgesics following laparoscopic cholecystectomy.Materials and Methods: Fifty patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomly divided into two groups. Twenty-five patients in Group B received subcostal TAP block with 0.25% bupivacaine 20 mL on each side and 25 patients in Group A received 0.9% normal saline 20 mL on each side after completion of surgery. Each patient's pain was assessed using visual analog scale (VAS) score at 0, 2, 4, 8, 16, and 24 h. The primary outcome measure was to compare the requirement of rescue analgesia, whereas secondary outcome measure was to compare satisfaction grades between the two groups. Comparison of quantitative and qualitative variables between groups was done using unpaired student's t-test and Chi-square test, respectively, using Statistical Package for the Social Sciences.Results: Percentage of patients who required paracetamol (P < 0.002) and nalbuphine (P < 0.001) as rescue analgesic was significantly less in Group B as compared to Group A. In all, 92% of Group B and 4% of Group A patients had a satisfactory overall quality of postoperative analgesia which was statistically significant (P < 0.002).Conclusion: Subcostal TAP block is an effective method of providing postoperative analgesia in patients undergoing laparoscopic cholecystectomy.