Significance of tap block in perioperative pain control in laparoscopic cholecystectomy

Abstract

Laparoscopic cholecystectomy is one of the most common minimally invasive operations in abdominal surgery and the gold standard in the treatment of symptomatic gallbladder diseases. Although it is a minimally invasive technique, the intensity of pain in the postoperative period can be significant, especially during the first 24 hours after surgery. Coping with this pain can be approached by traditional treatment with different classes of analgesics or by the use of multimodal analgesia, which includes their combination with regional anesthesia techniques. The most commonly used technique of regional anesthesia in laparoscopic cholecystectomy operations is the block of the transverse abdominal plane (TAP block). The TAP block is an ultrasound-guided local anesthetic injection technique in the plane between the internal oblique and transverse abdominal muscles, which leads to the involvement of the sensory nerves that innervate the anterior abdominal wall, thus achieving adequate perioperative pain control. The application of the TAP block dates back to the beginning of the 21st century, and since then it has been the subject of numerous studies that have dealt with the impact of the TAP block on the reduction of intraoperative opioid consumption, the intensity of postoperative pain, as well as on the reduction of the frequency of side effects caused by opioid analgesics. Due to its simple execution and great efficiency, the TAP block is used today as an analgesia strategy in numerous abdominal surgeries.