EP.TH.136Does laparoscopic transversus abdominis plane (TAP) block reduce postoperative opioid usage in bariatric patients?

Abstract

Abstract Introduction Laparoscopic TAP block has been used in various surgical subspecialties to reduce postoperative opioid requirement and hence its side effects. The aim of our study was to evaluate the effect of laparoscopic TAP block in bariatric surgery. Methods We performed a retrospective analysis in patients who underwent bariatric surgery by two surgeons at a metropolitan public hospital from January 2019 to March 2020. One surgeon routinely performed laparoscopic TAP block (TAP group) with 80ml of 0.2% ropivacaine and the other surgeon performed port-site infiltration (non-TAP group) with either 0.2% or 0.75% bupivacaine. Patients with chronic pain were excluded. Baseline characteristics (age, gender, pre-op BMI, types of bariatric surgery), postoperative usage of opioids (in recovery, in the first 24 hours and opioid dosage) and length of stay (LOS) were collected and analysed. Results Seventy-nine patients were included in this study, of which 46 (58.2%) received laparoscopic TAP block and 33 (41.8%) received port site infiltration. Opioid requirement rates were lower in the TAP group: 54.3% (n = 25/46) received no opioids in recovery and 21.7% (n = 21/46) in the first 24 hours, compared to 48.5% (n = 16/33) in recovery and 9.1% (n = 3/33) in the first 24hours in the non-TAP group. However, there was no statistically significant difference (p = 0.61 and p = 0.13 respectively) between the two groups. Mean LOS was comparable in both groups. Conclusion Our study showed a non-statistically significant trend in reducing postoperative opioid usage with laparoscopic TAP block. Further evaluation with a prospective randomised controlled trial is warranted.