Port site infiltration versus subcostal TAP block in laparoscopic cholecystectomy for postoperative analgesia

Abstract

Background/Aim: Many patients experience moderate to severe pain after laparoscopic cholecystectomy. We aimed to compare efficacy of subcostal TAP block vs port site infiltration for post-operative analgesia in these patients. Methods: Patients undergoing elective laparoscopic cholecystectomy under general anaesthesia were divided randomly into two groups of 30 each to receive either ultrasound-guided bilateral subcostal TAP block (T) with 0.25% ropivacaine total 20 ml each side or port-site infiltration with 0.25% ropivacaine 5 ml each at 4 ports (I) at the end of the surgery before extubation. NRS for pain was assessed serially at 0 time point (after extubation), 1, 2, 3, 6, 12 and 24 h after surgery. Time for first rescue analgesia was noted. Inj.tramadol was used for rescue analgesia. Chi-square test and independent t-test were used to compare qualitative and quantitative data, respectively. Result: Time to first rescue analgesia in group I was 5.7±0.98 hr and in group T was 9±1.29 hr (p value=0.0001). Mean tramadol consumption in group I was 200 ± 64.33mg and in group T was 113.33 ± 34.57mg (p value =0.0001). Mean NRS score in group T was significantly lower in group T as compared to group I. Conclusion:Ultrasound guided subcostal TAP block provides better post-operative analgesia compared to port site infiltration in laparoscopic cholecystectomy patients.