Effect of Transversus Abdominis Plane Block on Cost of Laparoscopic Cholecystectomy Anesthesia

Abstract

BackgroundUse of transversus abdominis plane (TAP) block for postoperative analgesia is continuously increasing. However, few studies have investigated intraoperative effects of TAP block. We aimed to study the effects of TAP block in terms of cost-effectiveness and consumption of inhalation agents.Material/MethodsForty patients undergoing laparoscopic cholecystectomy were enrolled in this study. Patients were randomly divided into 2 groups: Group 1 (n=20) patients received TAP block and Group 2 (n=20) patients did not receive TAP block. Standard anesthesia induction was used in all patients. For the maintenance of anesthesia, fractional inspired oxygen (FIO2) of 50% in air with desflurane was used with a fresh gas flow of 4 L/min. All patients were monitored with electrocardiography and for peripheral oxygen saturation (SpO2), end-tidal carbon dioxide (ET), heart rate (HR), noninvasive mean blood pressure (MBP), and bispectral index (BIS). Bilateral TAP blocks were performed under ultrasound guidance to Group 1 patients. The BIS value was maintained at between 40 and 50 during the surgery. The Dion formula was used to calculate consumption of desflurane for each patient.ResultsThere was no difference between the groups with respect to demographic characteristics of the patients. Duration of anesthesia, surgery time, and dosage of fentanyl were similar in the 2 groups. However, the cost and consumption of desflurane was significantly lower in Group 1.ConclusionsTotal anesthesia consumption was lower and the cost-effectiveness of anesthesia was better in TAP block patients with general anesthesia than in non-TAP block patients undergoing laparoscopic cholecystectomy.

Analgesic effects of ultrasound-guided transverse abdominis plane block using different volumes and concentrations of local analgesics after laparoscopic cholecystectomy

“…In many previous studies of the use of a TAP block in patients undergoing laproscopic cholecystectomy, there were no differences in terms of the haemodynamic parameters and the duration of anaesthesia between the study groups; and no complications were observed. 6 , 11 , 13 Similarly, there were no differences between the two groups in the present study in terms of demographic characteristics, duration of anaesthesia, haemodynamic parameters and the patient satisfaction scores.…”

Ultrasound-Guided Transversus Abdominis Plane Block for Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis

“…A total of 77 articles were relevant to the search terms, and 15 studies were potentially eligible for inclusion. After reading the full-text articles, 7 studies [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ] covering 355 participants were finally included into this review. The flow diagram for the selection is shown in figure 1 .…”

“…Risk assessment as recommended in the Cochrane Handbook is listed in table 2 . Six included studies clearly reported the methods of randomization [ 17 , 18 , 19 , 20 , 21 , 23 ] and 3 detailed the methods of double blinding [ 17 , 18 , 19 , 20 , 21 , 23 ]. Because of the small number of trials included, funnel plots for publication bias could not be reliably examined.…”

“…All included studies reported data about opioid requirements [ 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Compared with patients in the control group, intraoperative fentanyl consumption (MD = −27.85 µg, 95s% CI: −44.91 to −10.79, p = 0.001, I 2 = 96s%), morphine consumption in the recovery room (MD = −1.57 mg, 95s% CI: −3.0 to −0.14, p = 0.03, I 2 = 91s%; fig.…”

“…Data reporting PONV are described in 4 trials [ 15 , 17 , 18 , 19 ]. There was a lower incidence of PONV (RR = 0.48, 95s% CI: 0.28 to 0.81, p = 0.006, I 2 = 0s%) in patients receiving TAP blocks compared with those in the control group (fig.…”